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. 2020 Dec 11;11:615398. doi: 10.3389/fphar.2020.615398

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Copyright © 2020 Yang, Keshavjee and Liu

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Proposed mechanisms of alpha-1 antitrypsin (A1AT) in COVID-19 treatment. The entry of SARS-CoV2 into host cells is through the binding of viral S-protein to angiotensin converting enzyme 2 (ACE2) located on host cells, which is mediated by the transmembrane serine protease 2 (TMPRSS2). A1AT inhibits TMPRSS2, thus, reduces SARS-CoV-2 infection. In addition, A1AT can reduce acute inflammatory responses, cell death, neutrophil elastase trap formation, coagulative activity, and dysregulated immune responses.