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Research Project

Analysis of routine blood biomarkers of systemic inflammation in patients Pi*ZZ and Pi*SZ.

Principal Investigator:
Cristina Aljama
Hospital Universitari Vall d'Hebron
Start date:
November 2022
Contact E-mail:
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Chronic Obstructive Pulmonary Disease (COPD) has been demonstrated to be characterised by lung and systemic inflammation. Therefore serum biomarkers such as C-reactive protein, fibrinogen, lymphocyte counts, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, among others, have been studied in order to determine their association with the severity and prognosis of the disease.

In alpha-1 antitrypsin deficiency (AATD) little is known about routine-blood biomarkers and their relationship with the disease. Hence, the aim of our study is to identify the possible associations between serum biomarkers and clinical manifestations and severity of lung and liver disease in patients with AATD.



  • To determine the relationship between serum biomarkers of systemic inflammation and clinical phenotypes of AATD: emphysema, bronchiectasis, asthma and liver disease.
  • To investigate the association between serum biomarkers of systemic inflammation and the severity of lung disease measured by FEV1 and KCO in patients Pi*ZZ and Pi*SZ.

Inclusion criteria

Individuals with phenotype/genotype Pi*ZZ and Pi*SZ included in EARCO

Brief summary


  • Retrospective study performed with data from EARCO International registry of patients Pi*ZZ and Pi*SZ.
  • Variables: Sociodemographic and clinical data will be collected: history of exacerbations, data from CT scan: presence of emphysema, bronchiectasies, data from lung function test: espirometry and diffusion lung capacity, and liver elastography
  • Routine serum biomarkers will be collected: haemoglobin, platelets, leucocytes, neutrophils, lymphocytes, eosinophils, monocytes, basophyls, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), analine transaminase (ALT), aspartate transaminase (AST), C-reactive protein and fibrinogen. Other biomarkers will be calculated: FIB-4 score, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, eosinophil/lymphocyte ratio and eosinophil/ basophil ratio.
  • First, a descriptive analysis will be performed of patients Pi*ZZ and Pi*SZ.
  • Next, comparisons of serum biomarkers between patients Pi*ZZ with/ without liver and/or lung disease and between Pi*SZ with/without liver and/or lung disease will be conducted.
  • Correlations between serum biomarkers and FEV1, KCO and LSM will be analysed.
  • Finally, associations between biomarkers and clinical phenotypes such as emphysema, bronchiectasies, asthma and liver disease will be analysed both in PI*ZZ and PI*SZ patients.