However, there is evidence that increased inflammation is associated with AAT deficiency, such as GI inflammation in patients with ulcerative colitis, associated with the PiZ carriers,40 and neutrophil associated inflammation seen in the lungs of AAT deficient patients.41 Also, PiMZ subjects without airflow obstruction may have an IL-8 related neutrophilic inflammation in the pulmonary airways 42 and they are more likely to develop both liver (cirrhosis or fibrosis) and lung disease (emphysema).43 This evidence concerns the gene SERPINA1 and alpha 1-antitrypsin deficiency.