The selective advantage of alpha1-antitrypsin deficiency

Age of SERPINA1 gene PI Z mutation: Swedish and Latvian population analysis

Alpha 1-antitrypsin (A1AT) deficiency, one of the most common inborn errors of metabolism in Caucasians, is characterized by a low serum concentration of A1AT and a high risk of pulmonary emphysema and liver disease. The allelic frequency for the most common protease inhibitor (PI) Z mutation in the SERPINA1 gene is 2-5% in Caucasians of European descent. The objective of our study was to estimate the PI Z mutation age using molecular analysis in Latvian and Swedish populations, which have the highest frequency of PI Z mutation. DNA samples of heterozygous and homozygous PI Z allele carriers from Latvia (n = 21) and Sweden (n = 65) were analysed; 113 unrelated healthy donors from Latvia were used as a control group. MALDI-TOF analysis was performed on all samples. Pairwise Fst was computed to compare the PI Z mutation ages between the two populations and controls. A p value less than 0.05 was considered significant. Analysis of non-recombinant SNPs revealed that the PI Z mutation age was 2902 years in Latvia (SD 1983) and 2362 years in Sweden (SD 1614) which correlates with previous studies based on microsatellite analysis.

Intracellular serpins, firewalls and tissue necrosis

Luke and colleagues have recently attributed a new role to a member of the serpin superfamily of serine proteinase inhibitors. They have used Caenorhabditis elegans to show that an intracellular serpin is crucial for maintaining lysosomal integrity. We examine the role of this firewall in preventing necrosis and attempt to integrate this with current theories of stress-induced protein degradation. We discuss how mutant serpins cause disease either through polymerization or now, perhaps, by unleashing necrosis.

Small molecules block the polymerization of Z alpha1-antitrypsin and increase the clearance of intracellular aggregates

The Z mutant of alpha1-antitrypsin (Glu342Lys) causes a domain swap and the formation of intrahepatic polymers that aggregate as inclusions and predispose the homozygote to cirrhosis. We have identified an allosteric cavity that is distinct from the interface involved in polymerization for rational structure-based drug design to block polymer formation. Virtual ligand screening was performed on 1.2 million small molecules and 6 compounds were identified that reduced polymer formation in vitro. Modeling the effects of ligand binding on the cavity and re-screening the library identified an additional 10 compounds that completely blocked polymerization. The best antagonists were effective at ratios of compound to Z alpha1-antitrypsin of 2.5:1 and reduced the intracellular accumulation of Z alpha1-antitrypsin by 70% in a cell model of disease. Identifying small molecules provides a novel therapy for the treatment of liver disease associated with the Z allele of alpha1-antitrypsin.

[The effects of tobacco on children]

INTRODUCTION

Smoking remains an important topic. It is estimated that at present half the children born in France have been, or will be, exposed to the toxic effects of passive smoking. This paper aims to review the evidence of the effects of passive smoking, both intra and extra-uterine.

STATE OF THE ART

Extra-uterine passive smoking is implicated in numerous respiratory (asthma, allergy, infections...) and non respiratory diseases (neoplastic, dental, ophthalmic, digestive, cardio-vascular and infective). Intra-uterine exposure is even more dangerous and leads to abnormalities of the pregnancy (placental abnormalities, prematurity...), of the foetus (behavioural problems, malformations) and long term problems for the unborn child. Passive smoking is responsible for pulmonary morphological abnormalities (pulmonary hypoplasia, reduction in elasticity, increased deposition of collagen and alteration of alveolar structure) and functional disorders (reduced compliance, increased airways resistance, bronchial hyperreactivity). Finally it causes a disturbance of respiratory control, promoting all the factors responsible for sudden cot death.

CONCLUSIONS

The ill effects of passive smoking fully justify efforts to inform and persuade the medical profession of its duty to fight this scourge.