The loop sheet polymers formed by the Z protein are retained within the rough endoplasmic reticulum of hepatocytes forming periodic acid Schiff (PAS) positive hepatic inclusions [22], and this accumulation can lead to liver disease including hepatitis, cirrhosis and hepatocellular carcinoma [23] in PiZZ homozygotes. The gene discussed is PSMB7; the disease is hepatocellular carcinoma.