Despite PiS and PiZ variants represent approximately 95% of the AATd cases, there are other rare variants codified in the SERPINA1 gene, such as Siiyama, Mmalton, Mprocida, Mheerlen, Mmineral springs, Mnichinan, Pduarte, Wbethesda Zaugsberg, and Zbristol that could confer risk to COPD, but there are not enough studies to support it [5]. Here, SERPINA1 is linked to chronic obstructive pulmonary disease.