In vitro (Mulgrew et al., 2004) and in vivo (Mahadeva et al., 2005) studies implicate extracellular polymers as chemo-attractants for human neutrophils that could contribute to inflammation and lung damage and less common extra-pulmonary manifestations of α1AT deficiency (Gooptu and Lomas, 2008). This evidence concerns the gene SERPINA1 and hyperinsulinemic hypoglycemia, familial, 4.