Genetic risk factors for chronic obstructive pulmonary disease

There is no doubt that the main risk factor for chronic obstructive pulmona ry disease (COPD) is cigarette smoking. Much remains to be determined, howe ver, concerning the pathogenesis of this disease. One of the most important questions is why only 10% to 20% of chronic heavy smokers develop COPD.(31 ) There is clearly a relationship between smoking history and decline in lu ng function,(5) but smoking habits (i.e., pack years and duration of smokin g) were estimated to account for only approximately 15% of the variation in forced expiratory volume in 1 second (FEV1) levels.(5) Other factors there fore must contribute to the development of COPD. Environmental risk factors such as childhood viral respiratory infections, latent adenoviral infectio ns, and air pollution have been identified. There are also genetic factors that influence susceptibility to the detrimental effects of cigarette smoke and therefore to COPD.(78).