ZNF165 and alpha 1-antitrypsin deficiency: To our surprise, a set of genes including zinc finger protein 165, snail homolog 1 (Drosophila), and Krüppel-like transcription factors (KLFs) 4 (gut), 9 and 10, perfectly discriminated between patients with end-stage “normal” MM and ZZ AATD–related COPD (Figures 1 and 2).