Alpha-1-antitrypsin and chronic bronchitis in adult Nigerians

Abstract

Alpha-1-antitrypsin (A1AT) serum levels and phenotypes were determine d in 49 Nigerians with chronic bronchitis a n d 1(X) norma l controls. The A1AT phenotypes encountered were PiMM, 69% in chronic bronchitics, 98% in controls', PiMZ, 23% in chronic bronchitics, 1% in controls; PiLM, 2 % in chronic bronchitics, 1% in controls. There were three patients (6%) with the homozygous-deficient phenotype PiZZ. Spirometr y confirmed obstructive ventilatory pattern in the patients with chronic bronchitis, and the difference in the values obtained between the patients and controls was statistically significant (P < 0.01). Serum A1A T levels were within the normal range of 1.4-2.7 g/1 in all except the three patients with PiZZ. There was no significant difference in the A1A T serum levels between patients with chronic bronchitis a n d control subjects with the PiMM phenotype; tests of significance were not possible for the other phenotypes because of the small number of subjects. The observation of PiZZ in 6% of our patients with chronic bronchitis is in support of screening of this category of patients. Replacement therapy with alpha-1-antitrypsin inhibitor is currently under investigation and may be worthwhile in these patients if detected early.