Clinical And Familial Risk Factors For COPD Exacerbations

Exacerbations of chronic obstructive pulmonary disease (COPD) substantially impair quality of life and increase the burden of illness in individuals with COPD. Though relatives of COPD patients have increased risk for COPD, increased risk for COPD exacerbations in relatives has not been demonstrated. Edwin Silverman (Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA) and his colleagues analysed data from participants in the Boston Early-Onset COPD Study, a family-based study of the epidemiological and genetic determinants of COPD, for risk factors influencing COPD exacerbations.


This study shows that environmental tobacco smoke exposure significantly increases episodes of cough and phlegm in subjects with severe, early-onset COPD. In first-degree relatives of these subjects, a substantial proportion of whom had a history of smoking or severe airflow obstruction, those with prior pneumonia, chronic bronchitis, episodic wheezing and active smoking were at increased risk of exacerbations. First-degree relatives of individuals with COPD exacerbations were demonstrated to be more likely to experience exacerbations using one definition of COPD exacerbation, episodes of increased cough and phlegm.


These findings highlight the risk of passive tobacco smoke exposure in patients with COPD. The demonstration of increased risk for exacerbations in first-degree relatives of COPD patients suggests a genetic basis for susceptibility to COPD exacerbations.


The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 8,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).

European Respiratory Society