Professor David Lomas is Professor of Respiratory Medicine at the University of Cambridge. Although alpha 1 antitrypsin deficiency deficiency was first described in 1963, it was David Lomas who in a seminal publication in 1992 described the mechanism by which this protein is retained within the liver to cause cirrhosis. This involves a newly discovered type of protein-protein interaction termed loop-sheet polymerisation. This finding has had wide implications for other diseases characterised by beta strand linkage. These include Huntington’s disease, Alzheimer’s disease and the prion encephalopathies. These diseases may be grouped together as the conformational diseases and might be amenable to treatment with beta strand blockers.