ABSTRACT
Chronic obstructive pulmonary disease (COPD) is characterized by progressive development of airflow obstruction that is not fully reversible. The airflow obstruction is caused by a combination of small-airway narrowing and fibrosis and parenchymal destruction due to an exaggerated inflammatory response to noxious particles and gases. Although cigarette smoking is by far the most important risk factor, only 10-20% of smokers develop symptomatic COPD and <15% of the variation in lung function among smokers can be explained by the extent and duration of cigarette smoking. Therefore, differences in susceptibility to COPD in smokers must exist. Environmental risk factors, such as air pollution, occupational dusts and chemicals, and childhood viral respiratory infection have been identified as contributors to this variation. In this chapter we review evidence of genetic risk for COPD and genetic factors that might influence the response to therapy.
