Links Between Alpha-1 Deficiency And Asthma/ Allergies

Less than 5% of people with COPD have a rare genetic disorder called alpha-1 antitrypsin deficiency. This may result in a diagnosis of COPD even if you never smoked. New evidence suggests it may also cause allergies and asthma. So, here is what to know about alpha-1, asthma, and allergies.

What’s the link between asthma, allergies, and alpha-1 antitrypsin deficiency?

Alpha-1 antitrypsin deficiency is caused by a COPD gene. It’s caused by a mutation on the SERPINA1 gene. This may result in a diagnosis of emphysema. You can read about how this happens in my post, “What Is Alpha-1 Antitrypsin?”

In this post, I’d like to talk about the alpha-1/ asthma/ allergy link. What are researchers learning about links between alpha-1 deficiency and asthma and allergies?

What percentage of those with alpha-1 deficiency have asthma and allergies? A 2006 study of 757 participants intended to answer this question. Of these, 44.6% also had a diagnosis of asthma. Of these, 20-25% had a diagnosis of both asthma and allergies.¹

A study in 1997 had similar results. The authors of this study speculated that low alpha-1 antitrypsin levels in the lungs increased the risk of also developing asthma and allergies as well as emphysema and COPD.²

What’s the difference between emphysema, asthma, and allergies?

Emphysema

This is defined as the loss of lung tissue. As tissues break apart, air exchange units called alveoli are stretched all the way to the walls of your chest. This acts to stretch out airways, making them chronically narrow and obstructed. This may also be combined with chronically inflamed airways or chronic bronchitis. A combination of these effects causes airflow limitation that is not reversible. Airflow limitation that is not reversible is how COPD is defined. It is this airflow limitation that causes the feeling of shortness of breath. Emphysema is a progressive disease. However, symptoms can be minimized with treatment.

Asthma

They have airways that are chronically inflamed. This inflammation makes their airways hypersensitive to asthma triggers. These triggers may include common allergens like dust mites, pollens, animal dander, and mold spores. It may also include smoke, dust, fumes, strong smells, and strong emotions. Triggers make underlying airway inflammation worse. This worsening inflammation causes narrow and obstructed airways. This causes airflow limitation. But, with asthma, this airflow limitation is reversible with time or treatment. Because of this, asthma episodes can be prevented or made to be mild and easy to control when they do occur. This is called good asthma control. It can be obtained with proper asthma treatment.

Allergies

This is when your immune system abnormally responds to harmful allergens. When you’re exposed to allergens, your immune system responds by releasing chemicals. These chemicals cause inflammation of upper airways (nose, sinuses, throat) causing allergy symptoms of stuffy and runny nose, itchy throat, coughing, sneezing. They may also cause inflammation of your lower airways, thereby triggering asthma symptoms. Allergies can be controlled by avoiding or minimizing exposure to allergens. They may also be controlled by medicines used to treat allergies, which may include antihistamines (Claritin, Benadryl) or anti leukotriene antagonists (Singulair).

Research points to a link between the conditions

Links between these three medical conditions remain elusive. However, many physicians and some studies have verified that there is a link. Noted above is one theory attempting to explain the link. However, future research may lead to other theories. Either way, the fact that a link appears possible may entice doctors to screen for asthma and allergies in their patients diagnosed with alpha-1 antitrypsin deficiency. This is important as it may lead to better breathing, and better quality and longer length of life, in those diagnosed with this rare genetic disorder.