Cystic fibrosis (CF) is characterized by progressive and ultimately fatal pulmonary disease although there are notable variations in clinical features. This heterogeneity is thought to lie outside the cystic fibrosis transmembrane regulator (CFTR) gene locus and may stem from deficiencies in the antiproteinase screen that protects the lung from proteolytic attack. One hundred and fifty seven pa...

We were all taught that proteins have to fold correctly to be active and that the primary sequence of amino acids acts as the ’blueprint‘ for successful, productive folding. in recent years, we have also learnt how sensitive that blueprint is to change. For example, a single amino-acid change in the protein sequence, or a subtle change in temperature at which folding takes place, can lead to th...

Emphysema is a chronic progressive lung disease characterised by abnormal permanent enlargement of airspaces as a result of destruction of alveolar walls. Most patients develop emphysema as a consequence of smoking but 1–2% of patients with emphysema develop the condition as a result of a genetic deficiency of the plasma proteinase inhibitor á1-antitrypsin. The two common deficiency variants of...

?1-antitrypsin deficiency is characterised by the misfolding and intracellular polymerisation of mutant protein within endoplasmic reticulum (ER) hepatocytes. Small molecules that bind stabilise Z were identified via a DNA-encoded library screen. A subsequent structure based optimisation led to series highly potent, selective cellular active correctors.

A 47-year-old Caucasian male presented to the chest clinic with a 4-week history of exertional dyspnea. A chest radiograph showed mild hyperinflation without any focal pathology and spirometry showed a mild obstructive defect. In view of symptoms being disproportionate to spirometric and radiologic abnormalities, a thoracic CT scan was obtained. It revealed that there was evidence of bronchiect...

Hepatobiliary cancers are aggressive tumors that affect the liver and biliary tract responsible for nearly 550,000 deaths per year. The most common malignancy is hepatocellular carcinoma, risk factors include viral hepatitis infection, nonalcoholic steatohepatitis, excessive alcohol use. Other etiologies Wilson’s disease, α1-antitrypsin deficiency, cryptogenic cirrhosis. Clinicians should be aw...

Alpha-1 antitrypsin deficiency (AATD) is one of the most common genetic diseases and caused by mutations in SERPINA1 gene. The homozygous Pi*Z variant responsible for majority classic severe form alpha-1 deficiency, which characterized markedly decreased levels serum (AAT) with a strong predisposition to lung liver disease. diagnosis early treatment AATD-associated disease are challenges clinic...