Cellular Consequences of Z Alpha-1 Antitrypsin Accumulation and Prospects for Therapy

Sam Alam,1 Ravi Mahadeva,2

1. Senior Post Doctoral Research Fellow, Department of Medicine, University of Cambridge, Cambridge UK
2. Director Cambridge COPD Centre, Cambridge University Hospitals Foundation Trust, Associate Lecturer, Department of Medicine, University of Cambridge, UK

Disclosure: No potential conflict of interest.
Citation: EMJ Hepatol. 2013;1:44-51.


The Z variant (Glu342Lys) of α1-antitrypsin polymerises and accumulates in the hepatocyte endoplasmic reticulum predisposing to neonatal hepatitis and liver cirrhosis. The resultant secretory defect leaves the lungs vulnerable to elastolysis and early-onset emphysema. There is currently no cure for the liver or lung disease other than organ transplantation. This review discusses the evolving understanding of the molecular pathogenesis of the condition and how this has led to the emergence of novel treatment strategies for α1- antitrypsin-related liver disease.

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