Alpha₁ Antitrypsin Levels in Sarcoidosis: Relationship to Disease Activity

¹ Associate Professor of Medicine, Howard University College of Medicine, Director of Pulmonary Function Laboratory, Freedmen's Hospital
² Assistant Professor of Pediatrics, Pediatrics Genetics Unit, Howard University College of Medicine
³ Biochemist, Pediatrics Genetics Unit, Howard University College of Medicine
⁴ Professor of Medicine and Dean Emeritus, Howard University College of Medicine; Attending Physician, Freedmen's Hospital
⁵ Assistant Professor of Medicine, Howard University College of Medicine; Attending Physician, Freedmen's Hospital
⁶ Chief, Pulmonary Disease Division, Freedmen's Hospital

Alpha₁ antitrypsin levels measured by the trypsin inhibitory capacity method were increased in a group of 23 patients with active sarcoidosis not under treatment when compared with a group of 17 patients, with inactive sarcoidosis, or age and sex matched healthy controls. Twelve of these patients and two of the control subjects were also studied by the radial immunodiffusion method and cellulose acetate serum electrophoresis methods for measuring ₁ antitrypsin. Obstruction of larger airways was present in 10 of 40 sarcoidosis patients, while the remainder had either a restrictive or normal pattern. In eight patients, measurement of diffusing capacity and a closer assessment for airways obstruction was obtained with measurements of specific airway conductance, thoracic gas volumes, and static and dynamic lung compliance at several respiratory frequencies. Disease of smaller airways was present in six patients as determined by frequency dependence of their dynamic lung compliance. Since three were nonsmokers, airways obstruction was thought to be due to mechanical effects of granulomas. ₁ antitrypsin levels may be another useful determinant of disease activity and may be used to supplement other clinical and laboratory indices of activity.