From the Guidelines
Elevated alpha-1 antitrypsin (AAT) levels are generally not a cause for concern and do not require specific treatment, as they often indicate a normal response to inflammation or infection in the body. This protein is produced by the liver and helps protect tissues from damage caused by enzymes released during inflammation. An elevated AAT level is considered an acute phase reactant, meaning its levels increase as part of the body's natural defense mechanism. Common causes of elevated AAT levels include:
- Acute infections
- Inflammatory conditions (e.g., rheumatoid arthritis, inflammatory bowel disease)
- Pregnancy
- Certain cancers
- Oral contraceptive use No specific medication or intervention is typically needed for elevated AAT levels alone, as stated in the American Thoracic Society/European Respiratory Society statement 1. Instead, the focus should be on identifying and addressing the underlying cause of inflammation if present. If elevated AAT is found incidentally:
- Review the patient's medical history for potential causes of inflammation
- Perform a physical examination
- Consider additional tests if clinically indicated (e.g., CRP, ESR, specific disease markers) It's essential to note that while elevated AAT is generally benign, a deficiency in AAT can lead to serious conditions like emphysema and liver disease, as discussed in the American Thoracic Society/European Respiratory Society statement 1. Therefore, if AAT levels are tested, it's crucial to ensure they are not low rather than focusing solely on elevated levels.
From the Research
Elevation of Alpha 1 Antitrypsin (A1AT) Levels
Elevation of alpha 1 antitrypsin (A1AT) levels can indicate several conditions, including:
- Infection: A1AT levels can rise in response to infection 2, 3
- Inflammation: A1AT levels can increase in response to inflammation, as indicated by elevated serum C-reactive protein (CRP) levels 2, 3
- Injury: A1AT levels can rise in response to injury 2
- Estrogen levels: A1AT levels can be influenced by estrogen levels 2
- Cancer: Elevated A1AT levels have been observed in non-small cell lung and prostate cancer patients, and are significantly correlated with the stage of cancer 4
- Chronic obstructive pulmonary disease (COPD): Higher serum A1AT levels are associated with a worse systemic inflammation status and higher 10-year mortality in COPD patients 5
Relationship between A1AT Levels and Other Factors
The relationship between A1AT levels and other factors, such as CRP levels and genetic variants, is complex: