SERPINA1 and hyperinsulinemic hypoglycemia, familial, 4: Neutrophil serine proteases are implicated in the destruction of tissue in a wide range of diseases such as acute respiratory distress syndrome (ARDS), chronic obstructive lung disease, bronchiectasis, alpha-1 antitrypsin deficiency, cystic fibrosis, granulomatous angiitis, rheumatoid arthritis, and gout[44–51].