Pulmonary elastic recoil and diffusing capacity in subjects with intermediate concentrations of alpha-1 antitrypsin

Serum from 224 males investigated in a prospective study of respiratory disorders in a recently established asbestos industry has been estimated for alpha-1 antitrypsin (AAT) concentration by single radial immunodiffusion. Mean AAT concentration was 213-4 mg/dl). No subject with a markedly reduced level was found. A comprehensive range of lung function tests sensitive to changes anticipated in emphysema at a preclinical stage, included measurements of diffusing capacity and pulmonary elastic recoil. The 26 subjects with AAT concentration less than 150 mg/dl, were regarded as likely to comprise a majority of genotypes MZ and SS, and the 19 subjects with AAT concentration greater than 300 mg/dl were considered to comprise mainly MM. No difference in pulmonary function could be demonstrated between these two groups. Evidence of diminished pulmonary elastic recoil was found in nine smoking subjects whose AAT concentrations were normal and also in one young non-smoking subject with moderately severe asthma, whose AAT concentration was 140 mg/dl. It is concluded that in a male working population, evidence of diminished pulmonary elastic recoil is not a function of AAT concentration.