Article

Risk factors for the development of chronic obstructive pulmonary disease.

Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Medical Clinics of North America (Impact Factor: 2.8). 06/1996; 80(3):501-22. DOI: 10.1016/S0025-7125(05)70451-X
Source: PubMed

ABSTRACT Cigarette smoking clearly has been shown to be the major environmental risk factor predisposing to the development of COPD. Occupational exposures to dust and fumes, air pollution, passive smoke exposure, childhood respiratory infections, and diet may also contribute. Airway hyperresponsiveness is a risk factor for the development of decline in FEV1, but its role in the development of COPD remains uncertain. Alpha1-antitrypsin deficiency is an important genetic risk factor for COPD in the small minority of COPD patients who inherit this deficiency. Other genetic factors are likely involved but have not yet been identified. Elucidation of additional genetic risk factors may provide useful insights into the pathogenesis of COPD. Potential interactions between the various environmental and genetic risk factors may be extremely important in determining the variable development of COPD.

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    • "Tobacco smoking is the main risk factor for COPD but despite this only a fraction of smokers go on to develop the disease (Barnes 2000). While it has been suggested that susceptibility to tobacco smoke may refl ect a genetic component of the disease (Barnes 1999) the only genetic factor identifi ed so far in predisposing individuals to COPD is the α 1 -antitrypsin defi ciency (Silverman and Speizer 1996). The Angiotensin-converting enzyme (ACE) is a zinc metallo-peptidase that is highly expressed in lungs, where it degrades bradykinin and catalyses the formation of the Angiotensin II (AII); a powerful vasoconstrictor, infl ammatory modulator and cellular growth factor (Woods et al 2000). "
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