Skip to main content
SpringerLink
Log in
Book cover

Alpha-1 Antitrypsin Deficiency pp 249–262Cite as

Therapeutics: Alpha-1 Antitrypsin Augmentation Therapy

  • Protocol
  • First Online:

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1639))

Abstract

Subjects with alpha-1 antitrypsin deficiency who develop pulmonary disease are managed following general treatment guidelines, including disease management interventions. In addition, administration of intravenous infusions of alpha-1 proteinase inhibitor (augmentation therapy) at regular schedules is a specific therapy for individuals with AATD with pulmonary involvement.

This chapter summarizes the manufacturing differences of commercially available formulations and the available evidence of the effects of augmentation therapy. Biologically, there is clear evidence of in vivo local antiprotease effects in the lung and systemic immunomodulatory effects. Clinically, there is cumulative evidence of slowing lung function decline and emphysema progression. The optimal dose of augmentation therapy is being revised as well as more individualized assessment of who needs this therapy.

This is a preview of subscription content, log in via an institution.

Protocol
USD   49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Springer Nature is developing a new tool to find and evaluate Protocols. Learn more

References

  1. Campos MA, Alazemi S, Zhang G, Wanner A, Sandhaus RA (2009) Effects of a disease management program in individuals with alpha-1 antitrypsin deficiency. COPD 6(1):31–40. doi:10.1080/15412550802607410

    Article  PubMed  Google Scholar 

  2. American Thoracic Society/European Respiratory Society Statement (2003) Standards for the diagnosis and Management of Individuals with alpha-1 antitrypsin deficiency. Am J Respir Crit Care Med 168(7):818–900

    Article  Google Scholar 

  3. Hoffmann U, Bergler T, Rihm M, Pace C, Kruger B, Rummele P, Stoelcker B, Banas B, Mannel DN, Kramer BK (2009) Upregulation of TNF receptor type 2 in human and experimental renal allograft rejection. Am J Transplant 9(4):675–686. doi:10.1111/j.1600-6143.2008.02536.x

    Article  CAS  PubMed  Google Scholar 

  4. Lutfi RA, Liu CJ, Stoelinga C (2008) Level dominance in sound source identification. J Acoust Soc Am 124(6):3784–3792. doi:10.1121/1.2998767

    Article  PubMed  PubMed Central  Google Scholar 

  5. Stoelting S, Trefzer T, Kisro J, Steinke A, Wagner T, Peters SO (2008) Low-dose oral metronomic chemotherapy prevents mobilization of endothelial progenitor cells into the blood of cancer patients. In Vivo 22(6):831–836

    CAS  PubMed  Google Scholar 

  6. Lee S, Goh BT, Tideman H, Stoelinga PJ, Jansen JA (2009) Modular endoprosthesis for mandibular body reconstruction: a clinical, micro-CT and histologic evaluation in eight Macaca fascicularis. Int J Oral Maxillofac Surg 38(1):40–47. doi:10.1016/j.ijom.2008.11.020

    Article  CAS  PubMed  Google Scholar 

  7. Verdonck HW, Meijer GJ, Kessler P, Nieman FH, de Baat C, Stoelinga PJ (2009) Assessment of bone vascularity in the anterior mandible using laser Doppler flowmetry. Clin Oral Implants Res 20(2):140–144. doi:10.1111/j.1600-0501.2008.01631.x

    Article  PubMed  Google Scholar 

  8. Stoelting M, Geyer M, Reuter S, Reichelt R, Bek MJ, Pavenstadt H (2009) Alpha/beta hydrolase 1 is upregulated in D5 dopamine receptor knockout mice and reduces O2- production of NADPH oxidase. Biochem Biophys Res Commun 379(1):81–85. doi:10.1016/j.bbrc.2008.12.008

    Article  CAS  PubMed  Google Scholar 

  9. Crystal RG (1990) Alpha 1-antitrypsin deficiency, emphysema, and liver disease. Genetic basis and strategies for therapy. J Clin Invest 85(5):1343–1352. doi:10.1172/JCI114578

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Wewers MD, Casolaro MA, Sellers SE, Swayze SC, McPhaul KM, Wittes JT, Crystal RG (1987) Replacement therapy for alpha 1-antitrypsin deficiency associated with emphysema. N Engl J Med 316(17):1055–1062

    Article  CAS  PubMed  Google Scholar 

  11. Wewers MD, Casolaro MA, Crystal RG (1987) Comparison of alpha-1-antitrypsin levels and antineutrophil elastase capacity of blood and lung in a patient with the alpha-1-antitrypsin phenotype null-null before and during alpha-1-antitrypsin augmentation therapy. Am Rev Respir Dis 135(3):539–543

    CAS  PubMed  Google Scholar 

  12. Ma S, Lin YY, Turino GM (2007) Measurements of desmosine and isodesmosine by mass spectrometry in COPD. Chest 131(5):1363–1371. doi:10.1378/chest.06-2251

    Article  CAS  PubMed  Google Scholar 

  13. Fregonese L, Ferrari F, Fumagalli M, Luisetti M, Stolk J, Iadarola P (2011) Long-term variability of desmosine/isodesmosine as biomarker in alpha-1-antritrypsin deficiency-related COPD. COPD 8(5):329–333. doi:10.3109/15412555.2011.589871

    Article  PubMed  Google Scholar 

  14. Ma S, Lin YY, He J, Rouhani FN, Brantly M, Turino GM (2013) Alpha-1 antitrypsin augmentation therapy and biomarkers of elastin degradation. COPD 10(4):473–481. doi:10.3109/15412555.2013.771163

    Article  CAS  PubMed  Google Scholar 

  15. Kraaier K, Hartmann M, Stoel MG, von Birgelen C (2008) Intermittent spastic coronary occlusion at site of non-significant atherosclerotic lesion requiring stent implantation. Neth Heart J 16(11):390–391

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Carter GT, Jensen MP, Hoffman AJ, Stoelb BL, Abresch RT, McDonald CM (2008) Pain in myotonic muscular dystrophy, type 1. Arch Phys Med Rehabil 89(12):2382. doi:10.1016/j.apmr.2008.09.001

    Article  PubMed  Google Scholar 

  17. Jonigk D, Al-Omari M, Maegel L, Muller M, Izykowski N, Hong J, Hong K, Kim SH, Dorsch M, Mahadeva R, Laenger F, Kreipe H, Braun A, Shahaf G, Lewis EC, Welte T, Dinarello CA, Janciauskiene S (2013) Anti-inflammatory and immunomodulatory properties of alpha1-antitrypsin without inhibition of elastase. Proc Natl Acad Sci U S A. doi:10.1073/pnas.1309648110

    PubMed  PubMed Central  Google Scholar 

  18. Petrache I, Fijalkowska I, Zhen L, Medler TR, Brown E, Cruz P, Choe KH, Taraseviciene-Stewart L, Scerbavicius R, Shapiro L, Zhang B, Song S, Hicklin D, Voelkel NF, Flotte T, Tuder RM (2006) A novel antiapoptotic role for alpha1-antitrypsin in the prevention of pulmonary emphysema. Am J Respir Crit Care Med 173(11):1222–1228. doi:10.1164/rccm.200512-1842OC

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Rouhani F, Paone G, Smith NK, Krein P, Barnes P, Brantly ML (2000) Lung neutrophil burden correlates with increased pro-inflammatory cytokines and decreased lung function in individuals with alpha(1)-antitrypsin deficiency. Chest 117(5 Suppl 1):250S–251S

    Article  CAS  PubMed  Google Scholar 

  20. Bergin DA, Reeves EP, Meleady P, Henry M, McElvaney OJ, Carroll TP, Condron C, Chotirmall SH, Clynes M, O'Neill SJ, McElvaney NG (2010) Alpha-1 antitrypsin regulates human neutrophil chemotaxis induced by soluble immune complexes and IL-8. J Clin Invest 120(12):4236–4250. doi:10.1172/JCI41196

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Bergin DA, Reeves EP, Hurley K, Wolfe R, Jameel R, Fitzgerald S, McElvaney NG (2014) The circulating proteinase inhibitor alpha-1 antitrypsin regulates neutrophil degranulation and autoimmunity. Sci Transl Med 6(217):217ra211. doi:10.1126/scitranslmed.3007116

    Article  Google Scholar 

  22. Schmid ST, Koepke J, Dresel M, Hattesohl A, Frenzel E, Perez J, Lomas DA, Miranda E, Greulich T, Noeske S, Wencker M, Teschler H, Vogelmeier C, Janciauskiene S, Koczulla AR (2012) The effects of weekly augmentation therapy in patients with PiZZ alpha1-antitrypsin deficiency. Int J Chron Obstruct Pulmon Dis 7:687–696. doi:10.2147/COPD.S34560

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Stockley RA, Bayley DL, Unsal I, Dowson LJ (2002) The effect of augmentation therapy on bronchial inflammation in alpha1-antitrypsin deficiency. Am J Respir Crit Care Med 165(11):1494–1498. doi:10.1164/rccm.2109013

    Article  PubMed  Google Scholar 

  24. Seersholm N, Wencker M, Banik N, Viskum K, Dirksen A, Kok-Jensen A, Konietzko N (1997) Does alpha1-antitrypsin augmentation therapy slow the annual decline in FEV1 in patients with severe hereditary alpha1-antitrypsin deficiency? Wissenschaftliche Arbeitsgemeinschaft zur Therapie von Lungenerkrankungen (WATL) alpha1-AT study group. Eur Respir J 10(10):2260–2263

    Article  CAS  PubMed  Google Scholar 

  25. Survival and FEV1 decline in individuals with severe deficiency of alpha1-antitrypsin (1998) The alpha-1-antitrypsin deficiency registry study group. Am J Respir Crit Care Med 158(1):49–59

    Article  Google Scholar 

  26. Wencker M, Fuhrmann B, Banik N, Konietzko N (2001) Longitudinal follow-up of patients with alpha(1)-protease inhibitor deficiency before and during therapy with IV alpha(1)-protease inhibitor. Chest 119(3):737–744

    Article  CAS  PubMed  Google Scholar 

  27. Chapman KR, Bradi AC, Paterson D, Navickis RJ, Wilkes MM (2005) Slower lung function decline during augmentation therapy in patients with alpha-1 antitrypsin deficiency: results from the Canadian AIR registry. Proc Am Thorac Soc 2:A808

    Google Scholar 

  28. Chapman KR, Stockley RA, Dawkins C, Wilkes MM, Navickis RJ (2009) Augmentation therapy for alpha1 antitrypsin deficiency: a meta-analysis. COPD 6(3):177–184

    Article  PubMed  Google Scholar 

  29. Schluchter MD, Stoller JK, Barker AF, Buist AS, Crystal RG, Donohue JF, Fallat RJ, Turino GM, Vreim CE, Wu MC (2000) Feasibility of a clinical trial of augmentation therapy for alpha(1)-antitrypsin deficiency. The alpha 1-antitrypsin deficiency registry study group. Am J Respir Crit Care Med 161(3 Pt 1):796–801. doi:10.1164/ajrccm.161.3.9906011

    Article  CAS  PubMed  Google Scholar 

  30. Dirksen A, Friis M, Olesen KP, Skovgaard LT, Sorensen K (1997) Progress of emphysema in severe alpha 1-antitrypsin deficiency as assessed by annual CT. Acta Radiol 38(5):826–832

    Article  CAS  PubMed  Google Scholar 

  31. Dowson LJ, Newall C, Guest PJ, Hill SL, Stockley RA (2001) Exercise capacity predicts health status in alpha(1)-antitrypsin deficiency. Am J Respir Crit Care Med 163(4):936–941

    Article  CAS  PubMed  Google Scholar 

  32. Dawkins PA, Dowson LJ, Guest PJ, Stockley RA (2003) Predictors of mortality in alpha1-antitrypsin deficiency. Thorax 58(12):1020–1026

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Dirksen A, Dijkman JH, Madsen F, Stoel B, Hutchison DC, Ulrik CS, Skovgaard LT, Kok-Jensen A, Rudolphus A, Seersholm N, Vrooman HA, Reiber JH, Hansen NC, Heckscher T, Viskum K, Stolk J (1999) A randomized clinical trial of alpha(1)-antitrypsin augmentation therapy. Am J Respir Crit Care Med 160(5 Pt 1):1468–1472

    Article  CAS  PubMed  Google Scholar 

  34. Dirksen A, Piitulainen E, Parr DG, Deng C, Wencker M, Shaker SB, Stockley RA (2009) Exploring the role of CT densitometry: a randomised study of augmentation therapy in alpha1-antitrypsin deficiency. Eur Respir J 33(6):1345–1353. doi:10.1183/09031936.00159408

    Article  CAS  PubMed  Google Scholar 

  35. Stockley RA, Parr DG, Piitulainen E, Stolk J, Stoel BC, Dirksen A (2010) Therapeutic efficacy of alpha-1 antitrypsin augmentation therapy on the loss of lung tissue: an integrated analysis of 2 randomised clinical trials using computed tomography densitometry. Respir Res 11:136. doi:10.1186/1465-9921-11-136

    Article  PubMed  PubMed Central  Google Scholar 

  36. Gotzsche PC, Johansen HK (2010) Intravenous alpha-1 antitrypsin augmentation therapy for treating patients with alpha-1 antitrypsin deficiency and lung disease. Cochrane Database Syst Rev 7:CD007851. doi:10.1002/14651858.CD007851.pub2

    Google Scholar 

  37. Chapman KR, Burdon JG, Piitulainen E, Sandhaus RA, Seersholm N, Stocks JM, Stoel BC, Huang L, Yao Z, Edelman JM, McElvaney NG, RAPID Trial Study Group (2015) Intravenous augmentation treatment and lung density in severe alpha1 antitrypsin deficiency (RAPID): a randomised, double-blind, placebo-controlled trial. Lancet 386(9991):360–368. doi:10.1016/S0140-6736(15)60860-1

    Article  CAS  PubMed  Google Scholar 

  38. McElvaney NG, Burdon J, Holmes M, Glanville A, Wark PA, Thompson PJ, Hernandez P, Chlumsky J, Teschler H, Ficker JH, Seersholm N, Altraja A, Mäkitaro R, Chorostowska-Wynimko J, Sanak M, Stoicescu PI, Piitulainen E, Vit O, Wencker M, Tortorici MA, Fries M, Edelman JM, Chapman KR, RAPID Extension Trial Group (2017) Long-term efficacy and safety of α1 proteinase inhibitor treatment for emphysema caused by severe α1 antitrypsin deficiency: an open-label extension trial (RAPID-OLE). Lancet Respir Med 5(1):51–60. doi:10.1016/S2213-2600(16)30430-1

    Article  CAS  PubMed  Google Scholar 

  39. Lieberman J (2000) Augmentation therapy reduces frequency of lung infections in antitrypsin deficiency: a new hypothesis with supporting data. Chest 118(5):1480–1485

    Article  CAS  PubMed  Google Scholar 

  40. Campos MA, Sandhaus R (2004) Exacerbations of respiratory symptoms in patients with alpha-1 antitrypsin deficiency on augmentation therapy. Am J Respir Crit Care Med 169(7):A767

    Google Scholar 

  41. Needham M, Stockley RA (2005) Exacerbations in {alpha}1-antitrypsin deficiency. Eur Respir J 25(6):992–1000. doi:10.1183/09031936.05.00074704

    Article  CAS  PubMed  Google Scholar 

  42. Wencker M, Banik N, Buhl R, Seidel R, Konietzko N (1998) Long-term treatment of alpha1-antitrypsin deficiency-related pulmonary emphysema with human alpha1-antitrypsin. Wissenschaftliche Arbeitsgemeinschaft zur Therapie von Lungenerkrankungen (WATL)-alpha1-AT-study group. Eur Respir J 11(2):428–433

    Article  CAS  PubMed  Google Scholar 

  43. Stoller JK, Fallat R, Schluchter MD, O'Brien RG, Connor JT, Gross N, O'Neil K, Sandhaus R, Crystal RG (2003) Augmentation therapy with alpha1-antitrypsin: patterns of use and adverse events. Chest 123(5):1425–1434

    Article  CAS  PubMed  Google Scholar 

  44. Meyer FJ, Wencker M, Teschler H, Steveling H, Sennekamp J, Costabel U, Konietzko N (1998) Acute allergic reaction and demonstration of specific IgE antibodies against alpha-1-protease inhibitor. Eur Respir J 12(4):996–997

    Article  CAS  PubMed  Google Scholar 

  45. Mullins CD, Huang X, Merchant S, Stoller JK, Alpha One Foundation Research Network Registry I (2001) The direct medical costs of alpha(1)-antitrypsin deficiency. Chest 119(3):745–752

    Article  CAS  PubMed  Google Scholar 

  46. Mullins CD, Wang J, Stoller JK (2003) Major components of the direct medical costs of alpha1-antitrypsin deficiency. Chest 124(3):826–831

    Article  PubMed  Google Scholar 

  47. Mullins CD, Blatt L, Wang J (2002) Societal implications of the pharmacoeconomics of alpha1-antitrypsin deficiency. Expert Rev Pharmacoecon Outcomes Res 2(3):243–249. doi:10.1586/14737167.2.3.243

    Article  PubMed  Google Scholar 

  48. Sclar DA, Evans MA, Robison LM, Skaer TL (2012) alpha1-proteinase inhibitor (human) in the treatment of hereditary emphysema secondary to alpha1-antitrypsin deficiency: number and costs of years of life gained. Clin Drug Investig 32(5):353–360. doi:10.2165/11631920-000000000-00000

    Article  CAS  PubMed  Google Scholar 

  49. Alkins SA, O'Malley P (2000) Should health-care systems pay for replacement therapy in patients with alpha(1)-antitrypsin deficiency? A critical review and cost-effectiveness analysis. Chest 117(3):875–880

    Article  CAS  PubMed  Google Scholar 

  50. Gildea TR, Shermock KM, Singer ME, Stoller JK (2003) Cost-effectiveness analysis of augmentation therapy for severe alpha1-antitrypsin deficiency. Am J Respir Crit Care Med 167(10):1387–1392. doi:10.1164/rccm.200209-1035OC

    Article  PubMed  Google Scholar 

  51. Stockley RA, Miravitlles M, Vogelmeier C (2013) Augmentation therapy for alpha-1 antitrypsin deficiency: towards a personalised approach. Orphanet J Rare Dis 8(1):149. doi:10.1186/1750-1172-8-149

    Article  PubMed  PubMed Central  Google Scholar 

  52. Sandhaus RA, Turino G, Stocks J, Strange C, Trapnell BC, Silverman EK, Everett SE, Stoller JK (2008) Alpha1-Antitrypsin augmentation therapy for PI*MZ heterozygotes: a cautionary note. Chest 134(4):831–834. doi:10.1378/chest.08-0868

    Article  PubMed  Google Scholar 

  53. Campos MA, Alazemi S, Zhang G, Wanner A, Salathe M, Baier H, Sandhaus RA (2009) Exacerbations in subjects with alpha-1 antitrypsin deficiency receiving augmentation therapy. Respir Med 103(10):1532–1539. doi:10.1016/j.rmed.2009.04.008

    Article  PubMed  Google Scholar 

  54. Hubbard RC, Sellers S, Czerski D, Stephens L, Crystal RG (1988) Biochemical efficacy and safety of monthly augmentation therapy for alpha 1-antitrypsin deficiency. JAMA 260(9):1259–1264

    Article  CAS  PubMed  Google Scholar 

  55. Barker AF, Iwata-Morgan I, Oveson L, Roussel R (1997) Pharmacokinetic study of alpha1-antitrypsin infusion in alpha1-antitrypsin deficiency. Chest 112(3):607–613

    Article  CAS  PubMed  Google Scholar 

  56. Soy D, de la Roza C, Lara B, Esquinas C, Torres A, Miravitlles M (2006) Alpha-1-antitrypsin deficiency: optimal therapeutic regimen based on population pharmacokinetics. Thorax 61(12):1059–1064. doi:10.1136/thx.2005.057943

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Zamora NP, Pla RV, Del Rio PG, Margaleff RJ, Frias FR, Ronsano JB (2008) Intravenous human plasma-derived augmentation therapy in alpha 1-antitrypsin deficiency: from pharmacokinetic analysis to individualizing therapy. Ann Pharmacother 42(5):640–646. doi:10.1345/aph.1K505

    Article  CAS  PubMed  Google Scholar 

  58. Campos MA, Kueppers F, Stocks JM, Strange C, Chen J, Griffin R, Wang-Smith L, Brantly ML (2013) Safety and pharmacokinetics of 120 mg/kg versus 60 mg/kg weekly intravenous infusions of alpha-1 proteinase inhibitor in alpha-1 antitrypsin deficiency: a multicenter, randomized, double-blind, crossover study (SPARK). COPD 10(6):687–695. doi:10.3109/15412555.2013.800852

    Article  PubMed  Google Scholar 

  59. Stoel BC, Bode F, Rames A, Soliman S, Reiber JH, Stolk J (2008) Quality control in longitudinal studies with computed tomographic densitometry of the lungs. Proc Am Thorac Soc 5(9):929–933. doi:10.1513/pats.200804-039QC

    Article  PubMed  Google Scholar 

  60. Hubbard RC, Crystal RG (1990) Strategies for aerosol therapy of alpha 1-antitrypsin deficiency by the aerosol route. Lung 168(Suppl 1):565–578

    Article  CAS  PubMed  Google Scholar 

  61. Vogelmeier C, Kirlath I, Warrington S, Banik N, Ulbrich E, Du Bois RM (1997) The intrapulmonary half-life and safety of aerosolized alpha1-protease inhibitor in normal volunteers. Am J Respir Crit Care Med 155(2):536–541

    Article  CAS  PubMed  Google Scholar 

  62. Brantly ML, Spencer LT, Humphries M, Conlon TJ, Spencer CT, Poirier A, Garlington W, Baker D, Song S, Berns KI, Muzyczka N, Snyder RO, Byrne BJ, Flotte TR (2006) Phase I trial of intramuscular injection of a recombinant adeno-associated virus serotype 2 alphal-antitrypsin (AAT) vector in AAT-deficient adults. Hum Gene Ther 17(12):1177–1186. doi:10.1089/hum.2006.17.1177

    Article  CAS  PubMed  Google Scholar 

  63. Chiuchiolo MJ, Kaminsky SM, Sondhi D, Hackett NR, Rosenberg JB, Frenk EZ, Hwang Y, Van de Graaf BG, Hutt JA, Wang G, Benson J, Crystal RG (2013) Intrapleural administration of an AAVrh.10 vector coding for human alpha1-antitrypsin for the treatment of alpha1-antitrypsin deficiency. Hum Gene Ther Clinical Dev 24(4):161–173. doi:10.1089/humc.2013.168

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pulmonary, Sleep and Critical Care Medicine, Miller School of Medicine, University of Miami, RMSB Room 7043 A (R-47), 1600 NW 10th Ave., Miami, FL, 33136, USA

    Michael Campos M.D.

  2. Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Miami, FL, USA

    Jorge Lascano M.D.

Authors
  1. Michael Campos M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Lascano M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Campos M.D. .

Editor information

Editors and Affiliations

  1. Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA

    Florie Borel

  2. Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA

    Christian Mueller

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Science+Business Media LLC

About this protocol

Cite this protocol

Campos, M., Lascano, J. (2017). Therapeutics: Alpha-1 Antitrypsin Augmentation Therapy. In: Borel, F., Mueller, C. (eds) Alpha-1 Antitrypsin Deficiency . Methods in Molecular Biology, vol 1639. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-7163-3_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-7163-3_25

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-7161-9

  • Online ISBN: 978-1-4939-7163-3

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics

Search

Navigation