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Communications to the Editor |

Augmentation Therapy in α1-Antitrypsin Deficiency FREE TO VIEW

Jonathan G. W. Burdon, MD; Sue Brenton, B Appl Sc; Monna Ayad, BSc; Kenneth Knight, PhD
Author and Funding Information

Affiliations: Australasian α1-Antitrypsin Research Program,  Northridge, CA

Correspondence to: Jonathan G. W. Burdon, MD, Suite 68, Sixth Floor, Mercy Private Hospital, Consulting Suites, 166 Gipps St, East Melbourne, Australia 3002



Chest. 2001;120(2):687. doi:10.1378/chest.120.2.687
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Published online

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.

References

Lieberman, J (2000) Augmentation therapy reduces frequency of lung infections in antitrypsin deficiency: a new hypothesis with supporting data.Chest118,1480-1485. [PubMed] [CrossRef]
 
Seersholm, N, Wencker, M, Banik, N, et al Does α1-antitrypsin augmentation therapy slow the annual decline in FEV1in patients with severe hereditary α1-antitrypsin deficiency?Eur Respir J1997;10,2260-2263. [PubMed]
 
Wencker, M, Banik, N, Buhl, R, et al Long-term treatment of α1-antitrypsin deficiency-related pulmonary emphysema with human α1-antitrypsin.Eur Respir J1998;11,428-433. [PubMed]
 
Dirksen, A, Dijkman, JH, Madsen, F, et al A randomized clinical trial of α1-antitrypsin augmentation therapy.Am J Respir Crit Care Med1999;160,1468-1472. [PubMed]
 
Cantin, AM, Woods, DE Aerosolized prolastin suppresses bacterial proliferation in a model of chronic Pseudomonas aeruginosa lung infectionAm J Respir Crit Care Med1999;160,1130-1135. [PubMed]
 
Barker, AF, Siemsen, F, Pasley, D, et al Replacement therapy for hereditary α1-antitrypsin deficiency: a program for long-term administration.Chest1994;105,1406-1410. [PubMed]
 
To the Editor:

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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Tables

References

Lieberman, J (2000) Augmentation therapy reduces frequency of lung infections in antitrypsin deficiency: a new hypothesis with supporting data.Chest118,1480-1485. [PubMed] [CrossRef]
 
Seersholm, N, Wencker, M, Banik, N, et al Does α1-antitrypsin augmentation therapy slow the annual decline in FEV1in patients with severe hereditary α1-antitrypsin deficiency?Eur Respir J1997;10,2260-2263. [PubMed]
 
Wencker, M, Banik, N, Buhl, R, et al Long-term treatment of α1-antitrypsin deficiency-related pulmonary emphysema with human α1-antitrypsin.Eur Respir J1998;11,428-433. [PubMed]
 
Dirksen, A, Dijkman, JH, Madsen, F, et al A randomized clinical trial of α1-antitrypsin augmentation therapy.Am J Respir Crit Care Med1999;160,1468-1472. [PubMed]
 
Cantin, AM, Woods, DE Aerosolized prolastin suppresses bacterial proliferation in a model of chronic Pseudomonas aeruginosa lung infectionAm J Respir Crit Care Med1999;160,1130-1135. [PubMed]
 
Barker, AF, Siemsen, F, Pasley, D, et al Replacement therapy for hereditary α1-antitrypsin deficiency: a program for long-term administration.Chest1994;105,1406-1410. [PubMed]
 
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