Alpha-1-antitrypsin level as a predictor of acute exacerbations in chronic obstructive pulmonary disease: a prospective observational study

Background: This prospective study investigated if alpha-1-antitrypsin (AAT) levels could predict chronic obstructive pulmonary disease (COPD) exacerbations needing hospitalization. Methods: 106 COPD subjects hospitalized for acute exacerbations were enrolled. Past 2-years’ records were evaluated for prior exacerbation hospitalizations. AAT levels and post-stabilization FEV1 were assessed during current hospitalization. Exacerbation frequency correlated to current AAT levels and lung function. Results: Significant inverse association found between AAT levels and hospitalized exacerbations, indicating utility as a predictive biomarker for COPD patients prone to recurrent severe flares requiring admission. Patients with lower AAT levels also exhibited poorer lung function per lower FEV1 values. Conclusions: Monitoring AAT levels may promote timely interventions in high risk individuals susceptible to relapsing catastrophic exacerbations needing inpatient care. Further research warranted to validate findings and explore if supplementing deficient AAT reduces exacerbation frequency, thereby improving prognosis in this debilitating disease.