Alpha-one antitrypsin phenotypes in chest diseases in infants and children

In the present work, 92 infants and children were studied [52 males and 40 females] suffering from 5 common chest diseases: chronic broncho-pneumonia [15 patients], bronchiectasis [12 patients], bronchial asthma [20 patients], broncho-pneumonia [15 patients] and pulmonary TB [20 patients]. Bronchial asthma patients were subdivided into atopic [14 cases] and non atopic [6 cases] according to the results of IgE and allergic skin test, 30 normal children were taken as controls. All patients and controls were subjected to chest radiographs. CBS ESR, quantitative determination of serum ALAT by radial immunodiffusion methods and ALAT phenotyping by immunofixation electrophoresis. A second serum ALAT determination after 3 weeks of treatment was carried in chronic bronchitis, broncho- pnemonia and bronchial asthma group. It was done after 6 months in tuberculous patients. Serum ALAT in all patient groups, with the exception of bronchial asthma, was significantly higher than control at the initial estimation. As ALAT is one of the acute phase reactants it rises in active chest diseases. After treatment these high levels dropped to normal. In asthmatic patients, there is significant decrease of serum ALAT, both in atopic and non atopic cases. But the level was higher in patients with associated chest infection than in those without. As regards ALAT phenotyping the MM phenotype was the commonest. It was found in all controls, in 85% of TB. In asthmatics other pi variants [MS, MZ, SS], known to be ALAT phenotype variants than PiM were heterozygous deficient in ALAT and presented as recurrent chest infections or bronchial asthma