: PHARMACOTHERAPY 34 (6), pp. e99-e100, 2014.
OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is caused by the combination of smoking, genetic susceptibilityand exacerbated by bacterial infection. The genetic cause of COPD is a1-antitrypsin (AAT) deficiency. The goal of the study is to screen for AAT deficiency in the Egyptian population both phenotypically and genotypically to assess the contribution of (PI*S, PI*Z, PIMmalton and Q0Cairo) in the development of COPD in Egypt. The role of the bacterial burden in the COPD patients and its possible link to the AAT- deficiency genotype will be determined. Finally, any correlations between the identified mutations and/or the bacterial loads and the patients’ response to the medication will be determined.
METHODS: Three medical centers in Egypt participated in the study. Eligible patients (> GOLD II, < GOLD IV, FEV1/FVC ratio < 0.7, with post-bronchodilator FEV1 < 80% predicted) were offered testing for AATD, 6 minutes walk test and arterial blood gas (ABG).
RESULTS: A total of 21 patients were tested, of whom 20 were eligible. 25% were carriers (MZ). 65% showed single microbial species, 25% showed 2 microbial species and 10% had no microorganisms. Distribution of the isolated microorganisms based on Gram-reactions showed that 52.2% are Gram Positive while 47.8% are Gram Negative bacteria. Upon receiving treatment (LABA and Corticosteroid inhaler) for 6 months; 6 minutes walk test results increased by average 14.14%, FEV1/FVC ratio increased by average 20.75% and Oxygen Saturation increased by average 0.51%. Still the correlation between the gene variation and response to treatment is under investigation.
CONCLUSION: The prevalence of AATD among patients undergoing pulmonary function test was 25% MZ variant carriers. Pulmonary Function testing was effectively conducted
throughout the study.