SERPINA1 serpin family A member 1
Also known as: A1A, A1AT, A1AT_HUMAN, AAT, alpha-1 antiproteinase, alpha-1 antitrypsin, alpha-1 proteinase inhibitor, alpha1AT, PI, PI1, protease inhibitor 1 (anti-elastase), serine protease inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1, serpin peptidase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1.
Approximate pronunciation (generated from the name, not a recording):
- SERPINA1 ess-ee-are-pee-eye-en-ay-one
- serpin family A member 1 serpin family ay member one
What this gene does
The SERPINA1 gene provides instructions for making a protein called alpha-1 antitrypsin, which is a type of serine protease inhibitor (serpin). Serpins help control several types of chemical reactions by blocking (inhibiting) the activity of certain enzymes. The first identified role for alpha-1 antitrypsin was to control the activity of the digestive enzyme trypsin. Alpha-1 antitrypsin also inhibits other enzymes, including a powerful enzyme called neutrophil elastase that is released from white blood cells to fight infection.
Alpha-1 antitrypsin is produced in the liver and then transported throughout the body via the blood. Alpha-1 antitrypsin protects the lungs from neutrophil elastase, which can damage lung tissue if not properly controlled.
Source: MedlinePlus Genetics (reviewed 2009-08; source updated 2025-04-03).
Alpha-1 antitrypsin deficiency
Approximate pronunciation (generated from the name, not a recording):
- Alpha-1 antitrypsin deficiency alpha one antitrypsin deficiency
Also known as: AAT, AATD, Alpha-1 protease inhibitor deficiency, Alpha-1 related emphysema, Genetic emphysema, Hereditary pulmonary emphysema, Inherited emphysema.
What is Alpha-1 antitrypsin deficiency?
Alpha-1 antitrypsin deficiency is an inherited disorder that may cause lung disease and liver disease. The signs and symptoms of the condition and the age at which they appear vary among individuals.
People with alpha-1 antitrypsin deficiency usually develop the first signs and symptoms of lung disease between ages 25 and 50. The earliest symptoms are shortness of breath following mild activity, reduced ability to exercise, and wheezing. Other signs and symptoms can include unintentional weight loss, recurring respiratory infections, and fatigue. Affected individuals often develop emphysema, which is a lung disease caused by damage to the small air sacs in the lungs (alveoli). Characteristic features of emphysema include difficulty breathing, a hacking cough, and a barrel-shaped chest. Smoking or exposure to tobacco smoke accelerates the appearance of emphysema symptoms and damage to the lungs.
About 10 percent of infants with alpha-1 antitrypsin deficiency develop liver disease, which often causes yellowing of the skin and whites of the eyes (jaundice). Approximately 15 percent of adults with alpha-1 antitrypsin deficiency develop liver damage (cirrhosis) due to the formation of scar tissue in the liver. Signs of cirrhosis include a swollen abdomen and jaundice. Individuals with alpha-1 antitrypsin deficiency are also at risk of developing a type of liver cancer called hepatocellular carcinoma.
In rare cases, people with alpha-1 antitrypsin deficiency develop a skin condition called panniculitis, which is characterized by hardened skin with painful lumps or patches. Panniculitis varies in severity and can occur at any age.
Source: MedlinePlus Genetics (reviewed 2009-08; source updated 2025-04-03).
How it is inherited
This condition is inherited in an autosomal codominant pattern. Codominance means that two different versions of the gene may be active (expressed), and both versions contribute to the genetic trait.
The most common version (allele) of the SERPINA1 gene, called M, produces normal levels of alpha-1 antitrypsin. Most people in the general population have two copies of the M allele (MM) in each cell. Other versions of the SERPINA1 gene lead to reduced levels of alpha-1 antitrypsin. For example, the S allele produces moderately low levels of this protein, and the Z allele produces very little alpha-1 antitrypsin. Individuals with two copies of the Z allele (ZZ) in each cell have a high risk of developing lung disease (such as emphysema) and liver disease associated with alpha-1 antitrypsin deficiency. Those with the SZ combination have an increased risk of developing lung disease, particularly if they smoke.
Worldwide, it is estimated that 185 million people have one copy of the S or Z allele and one copy of the M allele in each cell (MS or MZ). Individuals with an MS (or SS) combination usually produce enough alpha-1 antitrypsin to protect the lungs. People with MZ alleles, however, have a slightly increased risk of impaired lung or liver function.
Source: MedlinePlus Genetics (reviewed 2009-08; source updated 2025-04-03).
How common it is
MedlinePlus Genetics Frequency
Alpha-1 antitrypsin deficiency occurs worldwide, but its prevalence varies by population. This disorder affects about 1 in 1,500 to 3,500 individuals with European ancestry. It is uncommon in people of Asian descent. Many individuals with alpha-1 antitrypsin deficiency are likely undiagnosed, particularly people with a lung condition called chronic obstructive pulmonary disease (COPD). COPD can be caused by alpha-1 antitrypsin deficiency; however, the alpha-1 antitrypsin deficiency is often never diagnosed. Some people with alpha-1 antitrypsin deficiency are misdiagnosed with asthma.
Source: MedlinePlus Genetics (reviewed 2009-08; source updated 2025-04-03).
Research studies
19 studies recruiting people with Alpha-1 antitrypsin deficiency. Showing the first 5 of 19.
- Screening for Alpha-1 Antitrypsin Deficiency in Patients With Airway Obstruction (NCT07152834)
- The Alpha-1 Foundation's and University of Florida's Alpha-1 Coded Testing (ACT) Study (NCT00500123)
- Gene Therapy for Alpha 1- Antitrypsin Deficiency (NCT06996756)
- Alpha-1 Research Registry (NCT04157049)
- A Study of AIR-001 in Adults With Alpha-1 Antitrypsin Deficiency (AATD) (NCT07431112)
See all recruiting studies on ClinicalTrials.gov.
Source: ClinicalTrials.gov (retrieved 2026-10-04).
Family and care
What a diagnosis can mean for a family, and what to ask. This guidance is general, not specific to one gene.
What is a genetic consultation?
A genetic consultation is a health service that provides information and support to people who have, or may be at risk for, genetic conditions. During a consultation, a genetics professional meets with an individual or family to discuss genetic risks or to diagnose, confirm, or rule out a genetic condition.
Genetics professionals include medical geneticists (doctors who specialize in genetics) and genetic counselors (certified healthcare workers with experience in medical genetics and counseling). Other healthcare professionals such as nurses, psychologists, and social workers trained in genetics can also provide genetic consultations.
Consultations usually take place in a doctor’s office, hospital, genetics center, or other type of medical center. These meetings are most often in-person visits with individuals or families, but they are occasionally conducted in a group. Additionally, genetic consultations may be carried out using telemedicine (also known as telehealth), in which the meeting is done from a distance using computers, cameras, videoconferencing tools, or the telephone.
Source: MedlinePlus Genetics.
Why might someone have a genetic consultation?
Individuals or families who are concerned about an inherited condition may benefit from a genetic consultation. The reasons that a person might be referred to a genetic counselor, medical geneticist, or other genetics professional include:
A personal or family history of a genetic condition, birth defect, chromosomal disorder, or hereditary cancer.
Two or more pregnancy losses (miscarriages), a stillbirth, or a baby who died.
A child with a known inherited disorder, a birth defect, intellectual disability, or developmental delay.
A woman who is pregnant or plans to become pregnant at or after age 35. (Some chromosomal disorders occur more frequently in children born to older women.)
Abnormal test results that suggest a genetic or chromosomal condition.
An increased risk of developing or passing on a particular genetic disorder on the basis of a person’s ethnic background.
People related by blood (for example, cousins) who plan to have children together. (A child whose parents are related may be at an increased risk of inheriting certain genetic disorders.)
A person received results from direct-to-consumer genetic testing and they want to discuss the implications of the results.
A genetic consultation is also an important part of the decision-making process for genetic testing. A visit with a genetics professional may be helpful even if testing is not available for a specific condition, however.
Source: MedlinePlus Genetics.
What happens during a genetic consultation?
A genetic consultation provides information, offers support, and addresses a patient’s specific questions and concerns. To help determine whether a condition has a genetic component, a genetics professional asks about a person’s medical history and takes a detailed family health history (a record of health information about a person's immediate and extended family). The genetics professional may also perform a physical examination and recommend appropriate medical tests.
If a person is diagnosed with a genetic condition, the genetics professional provides information about the diagnosis, how the condition is inherited, the chance of passing the condition to future generations, and the options for testing and treatment.
During a consultation, a genetics professional will:
Interpret and communicate complex medical information.
Help each person make informed, independent decisions about their health care and reproductive options.
Respect each person’s individual beliefs, traditions, and feelings.
A genetics professional will NOT:
Tell a person which decision to make.
Coerce a couple about whether or not to have children.
Recommend that a woman continue or end a pregnancy.
Tell someone whether to undergo testing for a genetic disorder.
Source: MedlinePlus Genetics.
What is genetic counseling?
The goal of genetic counseling is to help you learn more about the causes of genetic conditions and how they affect you.
Genetic counselors can: Review your family and medical histories; Explain how genetic conditions are passed down through families; Figure out if you or your family members are at risk for disease; Find and give you information about genetic conditions; Offer guidance to help you make informed choices or life plans; Provide information about testing options and help you decide what is best for you and your family; Help you find referrals to medical specialists, advocacy and support networks, and other resources.
Source: National Society of Genetic Counselors and Genetic Alliance (CC BY; published 2008).
Where to go next
- Alpha-1 antitrypsin deficiency: Alpha-1 Foundation — The patient advocacy organization for Alpha-1 antitrypsin deficiency.
- Find a Genetic Counselor (NSGC) — Find a genetic counselor near you.
- Search ClinicalTrials.gov for Alpha-1 antitrypsin deficiency — Look for studies that are recruiting people with Alpha-1 antitrypsin deficiency.
Words you may meet
Some technical words appear in the sections above and in the details below. Here is what they mean, in words from a public genetics glossary.
- Gene
- The gene is considered the basic unit of inheritance. Genes are passed from parents to offspring and contain the information needed to specify physical and biological traits. Most genes code for specific proteins, or segments of proteins, which have differing functions within the body. Humans have approximately 20,000 protein-coding genes. NHGRI Talking Glossary of Genomic and Genetic Terms
- Chromosome
- Chromosomes are threadlike structures made of protein and a single molecule of DNA that serve to carry the genomic information from cell to cell. In plants and animals (including humans), chromosomes reside in the nucleus of cells. Humans have 22 pairs of numbered chromosomes (autosomes) and one pair of sex chromosomes (XX or XY), for a total of 46. Each pair contains two chromosomes, one coming from each parent, which means that children inherit half of their chromosomes from their mother and half from their father. Chromosomes can be seen through a microscope when the nucleus dissolves during cell division. NHGRI Talking Glossary of Genomic and Genetic Terms
- Autosomal Recessive Disorder
- Autosomal recessive is a pattern of inheritance characteristic of some genetic disorders. “Autosomal” means that the gene in question is located on one of the numbered, or non-sex, chromosomes. “Recessive” means that two copies of the mutated gene (one from each parent) are required to cause the disorder. In a family where both parents are carriers and do not have the disease, roughly a quarter of their children will inherit two disease-causing alleles and have the disease. By contrast, an autosomal dominant disorder requires only a single copy of the mutated gene from one parent to cause the disorder. Sickle cell anemia is an example of an autosomal recessive genetic disorder. NHGRI Talking Glossary of Genomic and Genetic Terms
- Autosomal Dominant Disorder
- Autosomal dominant is a pattern of inheritance characteristic of some genetic disorders. “Autosomal” means that the gene in question is located on one of the numbered, or non-sex, chromosomes. “Dominant” means that a single copy of the mutated gene (from one parent) is enough to cause the disorder. A child of a person affected by an autosomal dominant condition has a 50% chance of being affected by that condition via inheritance of a dominant allele. By contrast, an autosomal recessive disorder requires two copies of the mutated gene (one from each parent) to cause the disorder. Huntington’s disease is an example of an autosomal dominant genetic disorder. NHGRI Talking Glossary of Genomic and Genetic Terms
- Mitochondrial DNA
- Mitochondrial DNA is the circular chromosome found inside the cellular organelles called mitochondria. Located in the cytoplasm, mitochondria are the site of the cell’s energy production and other metabolic functions. Offspring inherit mitochondria — and as a result mitochondrial DNA — from their mother. NHGRI Talking Glossary of Genomic and Genetic Terms
- Genetic Imprinting
- Genomic imprinting is the process by which only one copy of a gene in an individual (either from their mother or their father) is expressed, while the other copy is suppressed. Unlike genomic mutations that can affect the ability of inherited genes to be expressed, genomic imprinting does not affect the DNA sequence itself. Instead, gene expression is silenced by the epigenetic addition of chemical tags to the DNA during egg or sperm formation. Epigenetic tags on imprinted genes usually stay in place for the life of the individual. NHGRI Talking Glossary of Genomic and Genetic Terms
- Protein
- Proteins are large, complex molecules that play many important roles in the body. They are critical to most of the work done by cells and are required for the structure, function and regulation of the body’s tissues and organs. A protein is made up of one or more long, folded chains of amino acids (each called a polypeptide), whose sequences are determined by the DNA sequence of the protein-encoding gene. NHGRI Talking Glossary of Genomic and Genetic Terms
- Mutation
- A mutation is a change in the DNA sequence of an organism. Mutations can result from errors in DNA replication during cell division, exposure to mutagens or a viral infection. Germline mutations (that occur in eggs and sperm) can be passed on to offspring, while somatic mutations (that occur in body cells) are not passed on. NHGRI Talking Glossary of Genomic and Genetic Terms
- Pathogenic Variant
- A pathogenic variant is a genomic variant that may increase a person’s risk of developing a condition, disorder or disease. In many cases, carrying a pathogenic variant does not guarantee that a person will develop the specific condition but increases the risk for it. Pathogenic variants can be inherited from a parent or can occur spontaneously due to factors such as environmental exposure and aging. NHGRI Talking Glossary of Genomic and Genetic Terms
- Genetic Testing
- Genetic testing is the use of a laboratory test to examine an individual’s DNA for variations, typically performed in the context of medical care, ancestry studies or forensics. In a medical setting, the results of a genetic test can be used to confirm or rule out a suspected genetic disease. Results may also be used to determine the likelihood of parents passing on a genetic mutation to their offspring. Genetic testing may be performed prenatally or after birth. Genetic testing is also used to study the genomes of tumors in cancer cases. NHGRI Talking Glossary of Genomic and Genetic Terms
- Carrier
- A carrier, as related to genetics, is an individual who “carries” and can pass on to its offspring a genomic variant (allele) associated with a disease (or trait) that is inherited in an autosomal recessive or sex-linked manner, and who does not show symptoms of that disease (or features of that trait). The carrier has inherited the variant allele from one parent and a normal allele from the other parent. Any offspring of carriers is at risk of inheriting a variant allele from their parents, which would result in that child having the disease (or trait). NHGRI Talking Glossary of Genomic and Genetic Terms
- Allele
- An allele is one of two or more versions of DNA sequence (a single base or a segment of bases) at a given genomic location. An individual inherits two alleles, one from each parent, for any given genomic location where such variation exists. If the two alleles are the same, the individual is homozygous for that allele. If the alleles are different, the individual is heterozygous. NHGRI Talking Glossary of Genomic and Genetic Terms
- Mendelian Inheritance
- Mendelian inheritance refers to certain patterns of how traits are passed from parents to offspring. These general patterns were established by the Austrian monk Gregor Mendel, who performed thousands of experiments with pea plants in the 19th century. Mendel’s discoveries of how traits (such as color and shape) are passed down from one generation to the next introduced the concept of dominant and recessive modes of inheritance. NHGRI Talking Glossary of Genomic and Genetic Terms
Details you may see on a test report
These names and numbers are the technical ones doctors and labs use. You do not need to memorize them.
Location
This is where the gene sits on its chromosome, so you can match it to coordinates on a test report.
14q32.13 · GRCh38 chr14:94,376,745–94,391,024
Open in Ensembl (primary) or UCSC Genome Browser (secondary).
Source: HGNC (HGNC:8941).
Recommended transcript
This is the reference transcript labs use when they report a change in this gene.
- MANE Select
NM_000295.5(RefSeq) /ENST00000393087.9(Ensembl)
Source: NCBI MANE.
Protein domains
These are the working parts of the protein, with the amino-acid positions each one covers.
- Serpin domain — amino acids 54–415
Protein structure
This lets you look at the protein's 3D shape if you want to.
View the predicted structure in AlphaFold, or search the PDB for solved structures.
Source: UniProt (P01009).
Reported gene variants
ClinVar collects gene variants people have reported; it is a place to search, not a list on this page.
This page does not list individual variants. Search ClinVar for SERPINA1 instead.
Source: ClinVar.
What this page is not
This page is for education only. It is not medical advice, and it is not a diagnosis or a treatment plan. Talk with a doctor or a genetic counselor about your family's situation.