The goal of this study is to enroll up to a total of 13 AATD cases and 6 healthy controls. All AATD patients will be asked to give a blood sample and undergo a bronchoscopy. AATD patients will also be asked to undergo a follow up bronchoscopy and blood draw after 6 months of treatment with alpha-1 antitrypsin augmentation therapy to study the changes in these markers after augmentation therapy.