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The investigators hypothesize that there is liver injury (inflammation, fibrosis, cirrhosis) in adults with Alpha-1 Antitrypsin Deficiency (AATD), which is asymptomatic, under-recognized, and undiagnosed. In addition, the investigators believe that the genetic and environmental factors that play an important role in the development of alpha-1 antitrypsin (AAT) liver disease, can be identified by comparing a cohort database of clinical disease information to linked biospecimen and DNA samples.
Alpha-1 Antitrypsin Deficiency (AATD) is a genetic disorder resulting in a low level of a protein called alpha-1 antitrypsin (AAT). This deficiency can cause life-threatening liver disease and/or lung disease at various ages. Some patients experience life-threatening liver disease in childhood or liver cancer as adults. There is no specific treatment for AAT related liver disease. Some patients develop emphysema as young adults, while some patients remain healthy throughout their lives. Differences in the environment or in other genes may explain such inconsistency in the disease.
The primary objective of this multi-center study is to assess the natural history of individuals with Pi-ZZ AAT deficiency, identify biomarkers for the progression of liver disease and construct a database capable of linking cohort data with repository biospecimens. The secondary objective is to analyze components of the demographic, social, and family history associated with more severe liver disease.
At least 100 adults with Pi-ZZ AATD will be enrolled in the study. At the time of enrollment, each participant will be assigned a unique study identification (ID) number. All participant information recorded and samples collected for the study will be saved by this unique number. All blood, tissue and genetic samples collected will be sent to a secured repository for future retrieval and study. The process of coding data and samples lessens the chances of a breach in confidentiality.
The study will examine the natural history of liver disease by recording each participant's family history, medical history, current health, physical exam, laboratory test results, and medical treatment(s). Participants will complete several brief research questionnaires about their physical and mental health, diet, alcohol intake, smoking and secondhand smoke, environmental and occupational (work) exposures. Procedures performed for the research include liver biopsy, FibroScan testing, and the collection of serum, plasma and blood for routine laboratory and genetic testing (Induced Pluripotent Stem Cells (iPS cells), microRNA and DNA).
Participation in this study will last for 5 years and includes an enrollment visit and four annual follow-up visits. A liver biopsy is performed at enrollment and again in Year 5, to help the researchers learn what causes liver disease in some patients and how the liver disease progresses. Participants will be given copies of their routine laboratory test results and liver biopsy pathology reports to share with their primary care physician.
Observational Model: Cohort, Time Perspective: Prospective
Alpha-1 Antitrypsin Deficiency
University of California
St. Louis University
Published on BioPortfolio: 2015-04-03T08:38:22-0400
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