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alpha1-Antitrypsin: Key Player or Bystander in Acute Respiratory Distress Syndrome? #MMPMID33721888
Anesthesiology 2021[May]; 134 (5): 792-808 PMID33721888show ga
Acute respiratory distress syndrome is characterized by hypoxemia, altered alveolar-capillary permeability, and neutrophil-dominated inflammatory pulmonary edema. Despite decades of research, an effective drug therapy for acute respiratory distress syndrome remains elusive. The ideal pharmacotherapy for acute respiratory distress syndrome should demonstrate antiprotease activity and target injurious inflammatory pathways while maintaining host defense against infection. Furthermore, a drug with a reputable safety profile, low possibility of off-target effects, and well-known pharmacokinetics would be desirable. The endogenous 52-kd serine protease alpha1-antitrypsin has the potential to be a novel treatment option for acute respiratory distress syndrome. The main function of alpha1-antitrypsin is as an antiprotease, targeting neutrophil elastase in particular. However, studies have also highlighted the role of alpha1-antitrypsin in the modulation of inflammation and bacterial clearance. In light of the current SARS-CoV-2 pandemic, the identification of a treatment for acute respiratory distress syndrome is even more pertinent, and alpha1-antitrypsin has been implicated in the inflammatory response to SARS-CoV-2 infection.
Anesthesiology 2021 ; 134 (5): 792-808
