While Serpina1e deficiency has been well documented to associate with chronic obstructive pulmonary disease, Serpina1e is now also recognized as a cardioprotective protein (69), whereby genetic defects in Serpina1e promote atherosclerotic CVD (70) and atherosclerosis is inversely proportional to Serpina1e levels in rabbit models (71). Here, SERPINA1 is linked to chronic obstructive pulmonary disease.