The discrepancies between the two studies can be attributed to several factors: 1) a different monoclonal antibody used for detection of cell proliferation (MIB1 vs PCNA); 2) different case series including patients affected by emphysema in end-stage status and overall of different types (smoking-associated and AAT-deficiency emphysema), and 3) more analysis of extensive areas (upper and lower lobes) of emphysematous lung parenchyma. Here, SERPINA1 is linked to pulmonary emphysema.