Behavior of alpha-1-antitrypsin in adults with chronic liver disease

Alpha-1-antitrypsin (A1-AT) is a glycoprotein mainly sinthesized by the liver cells and its action is to inhibit the proteolytic enzymes operating in the acute stage of inflammation. An A1-AT inherited deficiency predisposes for the early onset of a variety of diseases ranging from panacinar emphysema to chronic pancreatic and liver diseases in children and adults. However, increased serum levels of A1-AT have been reported in patients suffering from various liver disease (i.e., acute and chronic hepatitis, cirrhosis). Therefore, in the present study A1-AT concentration were measured in 40 patients with chronic active hepatitis (CAH) and cirrhosis in order to verify, if higher levels correlate positively with the degree of biochemical and histological activity of the underlying liver disease. The highest concentrations of A1-AT were found in patients with CAH (4493 mg/l) and with active cirrhosis (4960 mg/l). These values are significantly different (p < 0.001) as compared to the control group and to the patients with non-active cirrhosis. This behavior of A1-AT supports its role as a serum marker of the inflammatory processes in the liver. Moreover, A1-AT could be a useful tool to monitor the evolution of chronic liver disease