What type of emphysema is associated with alpha-1 antitrypsin deficiency?

Panacinar emphysema is specifically associated with alpha-1 antitrypsin deficiency. This form of emphysema affects the entire acinus uniformly and is characterized by the destruction of alveolar walls. In the context of alpha-1 antitrypsin deficiency, the lack of this protein leads to unchecked activity of proteolytic enzymes, such as neutrophil elastase, which in turn results in the apoptosis of lung tissue. As a result, individuals with this deficiency commonly present with panacinar emphysema, especially affecting the lower lobes of the lungs.

The other types of emphysema listed do not have the same direct association with alpha-1 antitrypsin deficiency. Centrilobular emphysema primarily affects the central areas of the acini and is more commonly seen in smokers. Paraseptal emphysema is localized near the pleura and is often linked to other conditions such as pneumothorax. Mixed emphysema refers to a combination of different types but does not specifically relate to alpha-1 antitrypsin deficiency. Therefore, selecting panacinar emphysema as the type associated with this deficiency is accurate and reflects established medical understanding.