Characterization of the Pathobiology of Early Lung Destruction in Alpha 1-Antitrypsin Deficient Individuals

Any alpha 1 antitrypsin-deficient individuals. 18-65 years old. FEV1 greater than 1 equal to 50 percent of predicted (forced expiratory volume). Study participation is required for one year. A total of four bronchoscopies will be performed over a year period. Methacholine challenge test will be performed at the beginning and end of the study to assess the degree of reactive airways disease. Pneumococcal and annual influenza vaccine will be given. No prolastin within one year prior to start of the study. No oral systemic corticosteroids within 30 days prior to start of study. No allergy to topical or local anesthetic (i.e., lidocaine). No pregnancy. No HIV positive patients. No Hepatitis B/C virus positive patients. No patients with any condition associated with immunodeficiency. No patients with presence of significant cardiac diseases. No patients with presence of uncorrected blood-clotting disorders. No patients with any oxygen at home on a regular basis. No adverse reactions to methacholine.