title: Alpha-1-antitrypsin therapy ameliorates acute colitis and chronic murine ileitis.
abstract: BACKGROUND
  Fecal alpha-1-antitrypsin (AAT) clearance has been a marker of clinical disease severity in inflammatory bowel diseases (IBDs) for many years. Although AAT deficiency is more often associated with lung and liver pathologies, AAT-deficient patients with concomitant IBD have been shown to develop more aggressive disease and rapid progression to surgery. Although recent studies have highlighted the pleiotropic anti-inflammatory functions of AAT, including reducing proinflammatory cytokine production and suppressing immune cell activation, its potential therapeutic role in IBD has not been described.
  
  
  METHODS
  The therapeutic potential of human AAT administration was assessed in murine models of IBD including new-onset and established chemically induced colitis and spontaneous chronic murine ileitis. Histological assessment of inflammation, cytokine secretion profiling, and flow cytometric evaluation of inflammatory infiltrate were performed in each model. The effect of AAT on intestinal barrier function was also examined both in vitro and in vivo.
  
  
  RESULTS
  AAT attenuated inflammation in small and large intestinal IBD models through reduced secretion of proinflammatory cytokines, inflammatory cell infiltration, and reduced tissue injury. AAT also increased intestinal restitution after chemically induced colitis. AAT significantly decreased intestinal permeability in vitro and in vivo as part of a protective mechanism for both acute and chronic models of IBD.
  
  
  CONCLUSIONS
  Our findings describe a beneficial role for AAT in IBD models through suppression of cytokine production and enhanced intestinal barrier function. This raises the possibility that AAT supplementation, which has a long history of proven safety, may have a therapeutic effect in human IBD.
authors.affiliation: Mucosal Inflammation Program, Division of Gastroenterology, University of Colorado School of Medicine, Aurora, Colorado, USA. colm.collins@ucdenver.edu
authors.forename: Colm B
authors.initials: CB
authors.lastname: Collins
authors.forename: Carol M
authors.initials: CM
authors.lastname: Aherne
authors.forename: Stefan F
authors.initials: SF
authors.lastname: Ehrentraut
authors.forename: Mark E
authors.initials: ME
authors.lastname: Gerich
authors.forename: Eóin N
authors.initials: EN
authors.lastname: McNamee
authors.forename: Martine C
authors.initials: MC
authors.lastname: McManus
authors.forename: Matthew D P
authors.initials: MD
authors.lastname: Lebsack
authors.forename: Paul
authors.initials: P
authors.lastname: Jedlicka
authors.forename: Tania
authors.initials: T
authors.lastname: Azam
authors.forename: Edwin F
authors.initials: EF
authors.lastname: de Zoeten
authors.forename: Charles A
authors.initials: CA
authors.lastname: Dinarello
authors.forename: Jesús
authors.initials: J
authors.lastname: Rivera-Nieves
mesh_terms: D000208:Acute Disease; D000818:Animals; D002463:Cell Membrane Permeability; D002908:Chronic Disease; D003092:Colitis / Q000139:chemically induced / Q000276:immunology / Q000517:prevention & control*; D016207:Cytokines / Q000378:metabolism; D016264:Dextran Sulfate / Q000633:toxicity*; D005434:Flow Cytometry; D006801:Humans; D007079:Ileitis / Q000139:chemically induced / Q000276:immunology / Q000517:prevention & control*; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D051379:Mice; D000515:alpha 1-Antitrypsin / Q000627:therapeutic use*
chemical_list: D016207:Cytokines; C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D016264:Dextran Sulfate