Editor’s Note: Alpha-1 antitrypsin (AAT) protects tissues from enzymes of inflammatory cells, especially neutrophil elastase. It is excreted by neutrophils and macrophages during inflammation, and destroys both bacteria and host tissue.
Alpha-1 antitrypsin and chronic fatigue syndrome: a case study from pathophysiology to clinical practice
~Source: Pain Management, March 2013
By José Alegre at el.
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: Pain Management, March 2013, Vol. 3, No. 2, Pages 119-122 , DOI 10.2217/pmt.12.84. José Alegre, Chronic Fatigue Syndrome Unit, Hospital Vall d’Hebron, Passeig Vall Hebron 119-129, 08035 Barcelona, Spain; Sandra Camprubí, Clinical Trials & Pharmacovigilance Department, Instituto Grifols S.A. Can Guasch 2, 08150 Parets del Vallès, Barcelona, Spain; and Ana García-Quintana, Chronic Fatigue Syndrome Unit, Centro Médico Delfos, Avinguda de Vallcarca 151, 08023 Barcelona, Spain.