Review: α₁-Antitrypsin deficiency associated liver disease

α-Antitrypsin (α₁-AT) deficiency is the most common genetic cause of liver disease in children and genetic disease for which children undergo liver transplantation. It also causes cirrhosis and hepatocellular carcinoma in adults. Studies by Sveger in Sweden have shown that only a subgroup of the population with homozygous PiZZ α₁-AT deficiency develop clinically significant liver injury. Other studies have shown that the mutant α₁-AT Z molecule undergoes polymerization in the endoplasmic reticulum and that a subpopulation of α₁-AT-deficient individuals may be susceptible to liver injury because they also have a trait that reduces the efficiency by which the mutant α₁-AT Z molecule is degraded in the endoplasmic reticulum.