Alpha-1 antitrypsin and chronic fatigue syndrome: a case study from pathophysiology to clinical practice


Editor’s Comment: Alpha -1 Antitrypsin protects tissues from enzymes of inflammatory cells. The FDA has approved the use of three alpha 1-antitrypsin products derived from human plasma: Prolastin, Zemaira, and Aralast. Alpha -1 Antitrypsin treatment is extremely expensive.

By J. Alegre et al.


Background: Several lines of evidence support the involvement of inflammatory and immunologic abnormalities in chronic fatigue syndrome (CFS). Since recent studies have shown that alpha-1 antitrypsin (AAT) possesses anti-inflammatory properties, the potential therapeutic effect of AAT treatment on CFS has been investigated.

Case presentation: A 49-year-old woman diagnosed with CFS was treated with intravenous infusions of a human plasma-derived AAT concentrate (60 mg/kg body weight weekly for 8 consecutive weeks). The patient’s monocyte elastase, a regulator of inflammatory processes, was 1170 U/mg.

At completion of treatment, improvement in maximal workload was observed (54.0-71.7% of predicted). Additionally, amelioration in working memory (scores: 83-94) and perceptual organization (scores: 75-83) were detected on the Wechsler Adult Intelligence Scale-III test. Monocyte elastase decreased to a normal range (<150 U/mg). Improvement in functional capacity allowed the patient to work in part-time employment. Conclusion: These findings suggest a possible role for AAT in the treatment of CFS.

Source: Alegre J, Camprubí S, García-Quintana A. Pain Manag. 2013 Mar;3(2):119-22. doi: 10.2217/pmt.12.84.

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