Affiliations: Australasian α1-Antitrypsin Research Program,
Correspondence to: Jonathan G. W. Burdon, MD, Suite 68, Sixth Floor, Mercy Private Hospital, Consulting Suites, 166 Gipps St, East Melbourne, Australia 3002
To the Editor:
Dr. Lieberman’s article (November 2000)1–
provides important new information about the effect, or lack thereof,
of α1-antitrypsin in patients deficient in this
important protein. Although as yet unproved, the use of augmentation
therapy in this group of patients may reduce the rate of decline of
lung function3 and pulmonary tissue loss,4
at least in some individuals. Dr. Lieberman’s data indicate that there
may be other significant benefits to both the patient and community as
a result of the reduction in morbidity (respiratory infection) with its
consequent economic savings.
Dr. Lieberman’s data build on observations made by Cantin and
Woods5and Barker et al6 in 1994. The latter
group retrospectively analyzed a group ofα
1-antitrypsin-deficient patients who had
received augmentation therapy. They observed that “the conditions of
individuals in our program remained clinically and functionally stable
with several subjects having fewer hospitalizations than before
augmentation therapy was initiated.” Thus, there may be other
benefits from augmentation therapy. Further study of augmentation
therapy would seem sensible.
I deeply appreciate the comments by the members of the
Australasian α1-Antitrypsin Research Program regarding my
article. Their insight into the significance of my report supports my
findings and acknowledges the thoughtful consideration by the editors
of CHEST for allowing its publication. The article is one of
the first, or one of only a few, articles to report research conducted
via an Internet questionnaire, so that the reluctance of some reviewers
to recommend its publication is understood. The role ofα
1-antitrypsin in protecting the human organism from
various types of infections is just coming to light, so that a myriad
of future publications by various authors should be expected.
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