Abbreviations:A1AT, alpha-1-antitrypsin; AATD, alpha-1-antitrypsin deficiency; AUC, area under curve; B3gnt2, UDP-GlcNAc:betaGal beta-1,3-N-acetylglucosaminyltransferase 2; Cas9, CRISPR-associated protein 9; C1INH, C1 esterase inhibitor; CHO, Chinese hamster ovary; CRISPR, clustered regularly interspaced short palindromic repeats; FACS, fluorescence-activated cell sorting; FITC, Fluorescein isothiocyanate; Fut8, alpha-(1,6)-fucosyltransferase; Glul, glutamate-ammonia ligase; HAE, hereditary angioedema; HM, high-mannose; indel, insertion or deletion; IVC, integral of viable cells; KO, knock-out; mAb, monoclonal antibody; Mgat4A, mannosyl (alpha-1,3-)-glycoprotein beta-1,4-Nacetylglucosaminyltransferase isozyme A; Mgat4B, mannosyl (alpha-1,3-)glycoprotein beta-1,4-N-acetylglucosaminyltransferase isozyme B; Mgat5, mannosyl (alpha-1,6-)-glycoprotein beta-1,6-N-acetylglucosaminyltransferase; MSX, methionine sulfoximine; sgRNA, single guide RNA; SNA, sambucus nigra agglutinin; Sppl3, signal peptide peptidase like 3; St3gal3, ST3 beta-galactoside alpha-2,3-sialyltransferase 3; St3gal4, ST3 beta-galactoside alpha-2,3-sialyltransferase 4; St3gal6, ST3 beta-galactoside alpha-2,3-sialyltransferase 6; ST6GAL1, ST6 beta-galactoside alpha-2,6-sialyltransferase 1; VCD, viable cell density; WT, wild type Abstract Recombinant Chinese hamster ovary (CHO) cells are able to provide biopharmaceuticals that are essentially free of human viruses and have N-glycosylation profiles similar, but not identical, to humans. Due to differences in N-glycan moieties, two members of the serpin superfamily, alpha-1-antitrypsin (A1AT) and plasma protease C1 inhibitor (C1INH), are currently derived from human plasma for treating A1AT and C1INH deficiency.Deriving therapeutic proteins from human plasma is generally a cost-intensive process and also harbors a risk of transmitting infectious particles. Recombinantly produced A1AT and C1INH (rhA1AT, rhC1INH) decorated with humanized N-glycans are therefore of clinical and commercial interest.