Alpha-1-Antitrypsin Types and Chronic Obstructive Lung Disease in an Industrial Community in Northern Sweden

Beckman, G.; Beckman, L.; Mikaelsson, Bo; Rudolphi, Olle; Stjernberg, N; Wiman, Lars-Gösta

doi:10.1159/000153147

Cited by 14 publications

(17 citation statements)

References 4 publications

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“…However, our results indicate that this difference is due to smoking habits and occupational exposure at the Horne fors factories and not to rare Pi types. Thus, the present results indicate that indi viduals heterozygous for the MZ, MS and MF types do not have an increased risk for CB, a result which is in accordance with some reports [6,15,16] but not with others [5,17].…”

Section: Discussionsupporting

confidence: 93%

“…In the present study we were not able to show such an effect among individuals occupa tionally exposed to SOi or chlorine, nor was the serum level significantly increased in smokers compared to non-smokers. Low cq-AT serum levels in M type indi viduals were not associated with respirato ry disease in the present and in an earlier study of the Hornefors community [17], As in an earlier study [19] we have found a quantitative difference in serum levels between heterozygotes (M|Mi) and (M i + Mi) homozygotes.…”

Section: Discussionsupporting

confidence: 81%

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Alpha-1-Antitrypsin Types and Pulmonary Disease among Employees at a Sulphite Pulp Factory in Northern Sweden

Stjernberg¹,

Beckman

et al. 1984

Hum Hered

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Alpha-1-antitrypsin (α₁-AT) phenotypes and serum levels were measured in 518 employees at a sulphite pulp factory. There were 439 men and 79 women with the mean age of 42 years (range 18–65 years). Mean time of employment at the factory was 17.5 years and 216 (42%) individuals had been employed for more than 20 years. Chronic bronchitis was present in 47 (9.1 %) individuals. α₁-AT rare types (MZ, MS, MF) were present in 12.8% of the individuals with chronic bronchitis compared to 8.4% in employees with no respiratory symptoms, the difference being not statistically significant. Individuals with chronic bronchitis and rare types were evenly distributed with regard to work place at the factory. Serum levels of α₁-AT were somewhat higher in smokers compared to non-smokers, but the difference was not statistically significant. Exposure to SO₂ and chlorine did not seem to affect the serum levels of α₁-AT in M type individuals. In the present study, individuals heterozygous for α₁-AT deficiency phenotypes (MZ, MS, MF) did not seem to have an increased rate of chronic bronchitis. However, the rate of chronic bronchitis in factory employees was significantly increased compared to that among non-employees in the surrounding community. This increase appears to be due to a higher rate of smoking and to occupational exposure (SO₂ and chlorine) among the sulphite pulp factory workers.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 81%

Alpha-1-Antitrypsin Types and Pulmonary Disease among Employees at a Sulphite Pulp Factory in Northern Sweden

Stjernberg¹,

Beckman

et al. 1984

Hum Hered

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“…To account for environmental exposures, some population-based cross-sectional studies compared MZ to MM groups among industry workers [18,61,75]. Some of the studies that found an increased frequency of MZ genotypes in industry workers with COPD lacked matching for age and smoking [61,76]. HORNE et al [18] compared MZ and MM grain workers and matched for age, years of employment and smoking.…”

Section: Effects Of Environmental and Occupational Exposuresmentioning

confidence: 99%

COPD in individuals with the PiMZ alpha-1 antitrypsin genotype

Ashry

Strange

2017

Eur Respir Rev

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Since the discovery of severe alpha-1 antitrypsin deficiency as a genetic risk factor for emphysema, there has been ongoing debate over whether individuals with intermediate deficiency with one protease inhibitor Z allele (PiMZ, or MZ) are at some risk for emphysema. This is important, because MZ individuals comprise 2-5% of the general population. In this review we summarise the evidence about the risks of the MZ population to develop emphysema or asthma. We discuss the different study designs that have tried to answer this question. The risk of emphysema is more pronounced in case-control than in population-based studies, perhaps due to inadequate power. Carefully designed family studies show an increased risk of emphysema in MZ smokers. This is supported by the rapid decline in lung function of MZ individuals when compared to the general population after massive environmental exposures. The risk of asthma in MZ subjects is less studied, and more literature is needed before firm conclusions can be made. Augmentation therapy in MZ individuals is not supported by any objective studies. MZ smokers are at increased risk for emphysema that is more pronounced when other environmental challenges are present.

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“…In some of these studies it seemed that a deficit in c~l Pi tended to reveal or to increase the risk of p u l m o n a r y impairment related to occupational exposures. Beckman (2) found that bronchitis was related to SO2, C12 and smoking habits in subjects with phenotypes MS, MZ, FM, Z. Rosehall ,(16) also found that chronic bronchitis tended to be more frequent among such ~l Pi deficient subjects exposed to SO2 and Clv Tattersall (.17) also reported that alveolar abnormalities without bronchial abnormalities tended to be more frequently observed in MZ subjects. Pulmonary s y m p t o m s were more frequently observed by Chan Yeung et al (6) among non-smokers with phenotype MS, but this author considers that heterozygotism is not a noticeable risk factor in association with low levels of exposure to wood or grain dusts.…”

Section: T a B L E 8 --L U N G F U N C T I O N Tests: C H A N G E S mentioning

confidence: 95%

Respiratory symptoms and pulmonary function in 871 miners according to Pi phenotype: A longitudinal study

et al. 1988

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Pi phenotype was determined and alpha 1 protease inhibitor (alpha 1 Pi) was measured in 871 iron-ore miners examined twice at five years interval. A questionnaire on respiratory symptoms was administered and lung function tests: spirometry (VC, FEV1.0), measurements of the residual volume (RV/TLC) and of the CO diffusion (FuCO), were carried out by the same medical and technical team, using the same apparatus. There were no differences in age, length of employment or smoking habits among the three Pi Phenotype groups: M (90.03%), MS (7.1%), MZ (2.8%). The prevalence of clinical symptoms at the initial survey and the incidence of symptoms between the 2 surveys were not related to Pi Phenotype groups. However a significantly steeper decline of FEV1.0/VC was observed in the alpha 1 Pi partially deficient groups MS and MZ (-3.9%) compared with the non-deficient group (-1.8%). No significant difference was observed for VC, RV/TLC and FuCO. This finding suggests that an intermediate deficiency of alpha 1 Pi may be related to a slight but statistically significant impairment of a lung function in occupational conditions.

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Alpha-1-Antitrypsin Types and Chronic Obstructive Lung Disease in an Industrial Community in Northern Sweden

Cited by 14 publications

References 4 publications

Alpha-1-Antitrypsin Types and Pulmonary Disease among Employees at a Sulphite Pulp Factory in Northern Sweden

Alpha-1-Antitrypsin Types and Pulmonary Disease among Employees at a Sulphite Pulp Factory in Northern Sweden

COPD in individuals with the PiMZ alpha-1 antitrypsin genotype

Respiratory symptoms and pulmonary function in 871 miners according to Pi phenotype: A longitudinal study

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