Few smokers develop COPD. Why?

Respiratory Medicine

Volumn 96, Issue 8, 2002, Pages 615-624

  Siafakas, N M ^a   Tzortzaki, E G ^a  

^a UNIVERSITY OF CRETE   (Greece)

Author keywords

Airway hyperresponsiveness; Airway remodeling; Chronic bronchitis; Emphysema; Genetics; Oxidative stress; Susceptible smoker

Indexed keywords

ALPHA 1 ANTICHYMOTRYPSIN; ALPHA 1 ANTITRYPSIN; ALPHA 2 MACROGLOBULIN; BLOOD GROUP ANTIGEN; CATHEPSIN G; CIGARETTE SMOKE; IMMUNOGLOBULIN; MICROSATELLITE DNA; SECRETORY LEUKOCYTE PROTEINASE INHIBITOR; SUPEROXIDE DISMUTASE; TUMOR NECROSIS FACTOR ALPHA; VITAMIN D BINDING PROTEIN;

ADENOVIRUS; ARTICLE; CHRONIC OBSTRUCTIVE LUNG DISEASE; CIGARETTE SMOKING; DISEASE PREDISPOSITION; ENVIRONMENTAL EXPOSURE; EPIDEMIOLOGY; GENE IDENTIFICATION; GENE LOCUS; GENE MUTATION; GENETIC ANALYSIS; GENETIC RISK; GENETIC VARIABILITY; HOST; IMMUNOGLOBULIN DEFICIENCY; INFLAMMATION; MEDICAL LITERATURE; NUTRITIONAL STATUS; OXIDATIVE STRESS; PATHOGENESIS; PRIORITY JOURNAL; PROTECTION; RISK FACTOR; TISSUE INJURY; TISSUE REPAIR; VIRUS INFECTION;

EID: 0036695261     PISSN: 09546111     EISSN: None     Source Type: Journal    
DOI: 10.1053/rmed.2002.1318     Document Type: Article

References (124)

1. Fletcher C, Peto R, Tinker C, et al. The Natural History of Chronic Bronchitis and Emphysema. Oxford: Oxford University Press, 1976.
2. Burrows B, Bloom JW, Traver GA, et al. The course and prognosis of different forms of chronic airways obstruction in a sample from the general population. N Engl J Med 1987; 317: 1309-1314.
3. Rijcken B, Britton J. Epidemiology of chronic obstructive pulmonary disease. In: Postma IDS, Siafakas NM (eds). Management or Chronic Obstructive Pulmonary Disease. European Respiratory Monograph, Vol.7. Sheffield, U.K., 1998. 41-72.
4. Siafakas NM, Postma DS. Future research in chronic obstructive pulmonary disease. In Postma DS, Siafakas NM (eds). Management of Chronic Obstructive Pulmonary Disease. European Respiratory Monograph, Vol.7. Sheffield, U.K., 1998. 299-302.
5. Powels RA, Buist Sonia, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 163: 1256-1276.
6. Rahman I, Morrison D, Donaldson K, et al. Systemic oxidative stress in asthma, COPD, and smokers. Am J Respir Crit Care Med 1996; 154: 1055-1060.
7. Pryor WA. Biological effects of cigarette smoke, wood smoke and the smoke from plastics: the use of electron spin reasonance. Free Radic Biol Med 1992; 13: 659-676.
8. Ludwig PW, Hoidal JR. Alterations in leukocyte oxidative metabolism in cigarette smokers. Am Rev Respir Dis 1982; 126: 977-980.
9. Repine JE, Bast A, Lankhorst I. Oxidative stress in chronic obstructive pulmonary disease. Am J Respir Crit Care Des 1997; 156: 341-357.
10. Kao RC, Whener NG, Skubitz KM, et al. Proteinase 3: a distinct human polymorphonuclear leukocyte proteinase which produces emphysema in hamsters. J Clin Invest 1988; 82: 1963-1973.
11. Hautamaki RD, Kobayashi DK, Senior RM, et al. Requirement for macrophage elastase for cigarette smoke-induced emphysema in mice. Science 1997; 277: 2002-2004.
12. Hoidal JR, Jeffery PK. Cellular and biochemical mechanisms in chronic obstructive pulmonary disease. In:Postma IDS, Siafakas NM (eds). Management of Chronic Obstructive Pulmonary Disease. European Respiratory Monograph, Vol.7. Sheffield, U.K., 1998. 84-91.
13. DeForge LE, Preson AM, Takeuchi E, et al. Regulation of interleukin 8 gene expression by oxidant stress. J Biol Chem 1993; 268: 25 568-25 576.
14. Sellak H, Franzini E, Hakim J, et al. Reactive oxygen species rapidly increase endothelial ICAM-1 ability to bind neutrophils without detectable upregulation. Blood 1994; 83: 2669-2677.
15. Pardo A, Selman M. Proteinase-antiproteinase imbalance in the pathogenesis of emphysema: the role of metalloproteinases in lung damage. Histol Histopathol 1999; 14: 227-233.
16. Marui N, Offermann MK, Swerlick R, et al. Vascular cell adhesion molecule-1 (VCAM-1) gene transcription and expression are regulated through an antioxidant-sensitive mechanism in human vascular endothelial cells. J Clin Invest 1993; 92: 1866-1874.
17. Andreoli SP, Mallett C, McAteer JA, et al. Antioxidants defense mechanisms of endothelial cells and renal tubular epithelial cells in vitro: role of the glutathione redox cycle and catalase. Pediatr Res 1992; 32: 360-365.
18. Trevani AS, Andoegui G, Giordano M, et al. Neutrophil apoptosis induced by proteolytic enzymes. Lab Invest 1996; 74: 711-721.
19. Smyth MJ, Trapani JA. Granzymes: exogenous proteinases that induce target cell apoptosis. Immunol Today 1995; 16: 202-206.
20. Di Stefano A, Capelli A, Lusuardi M, et al. Severity of airflow limitation is associated with severity of airway inflammation in smokers. Am J Respir Crit Care Med 1998; 158: 1277-1286.
21. Keatings VM, Collins PD, Scott DM, et al. Differences in interleukin-8 and tumor necrosis factor-a in induced sputum from patients with chronic obstructive pulmonary disease or asthma. Am J Respir Crit Care Med 1996; 153: 530-534.
22. Saetta M, Turato G, Facchini FM, et al. Inflammatory cells in the bronchial glands of smokers with chronic bronchitis. Am J Respir Crit Care Med 1997; 156: 1633-1639.
23. O'Shaughnessy TC, Ansari TW, Barnes NC, et al. Inflammatory cells in the airway surface epithelium of bronchitic smokers with and without airflow obstruction. Eur Respir J 1996; 9: 14S.
24. Majori M, Gabrielli M, Cuomo A, et al. Cellular inflammation in chronic obstructive bronchitis. Eur Respir J 1995; 8: 227S.
25. Witko-Sarsat V, Halbwachs-Mecarelli L, Schuster A, et al. Proteinase 3, a potent secretagogue in airways, is present in cystic fibrosis sputum. Am J Respir Cell Mol Biol 1999; 20: 729-736.
26. Di Stefano A, Maestrelli P, Roggeri A, et al. Upregulation of adhesion molecules in the bronchial mucosa of subjects with chronic obstructive bronchitis. Am J Respir Crit Care Med 1994; 149: 803-810.
27. Stockley RA. Cellular mechanisms in the pathogenesis of COPD. Eur Respir Rev 1996; 6: 264-269.
28. Flinkelstein R, Fraser RS, Ghezzo H, et al. Alveolar inflammation and its relation to emphysema in smokers. Am J Respir Crit Care Med 1995; 152: 1666-1672.
29. + T-lymphocytes in peripheral airways of smokers with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 822-826.
30. Liu AN, Mohammed AZ, Rice WR, et al. Perforin-independent CD8(+) T-cell-mediated cytotoxicity of alveolar epithelial cells is preferentially mediated by tumor necrosis factor-alpha: relative insensitivity to Fas ligand. Am J Respir Cell Mol Biol 1999; 20: 849-858.
31. 1. Am J Respir Crit Care Med 1997; 155: 852-857.
32. Lacoste JY, Bousquet J, Chanez P. Eosinophilic and neutrophilic inflammation in asthma, chronic bronchitis and chronic obstructive pulmonary disease J Allergy Clin Immunol 1993; 92: 537-548.
33. Mueller R, Chanez P, Campbell AM, et al. Different cytokine patterns in bronchial biopsies in asthma and chronic bronchitis. Respir Med 1996; 90: 79-85.
34. Saetta M, Di Stefano A, Maestrelli P, et al. Airway eosinophilia in chronic bronchitis during exacerbations. Am J Respir Crit Care Med 1994; 150: 1646-1652.
35. Wyatt TA, Heires AJ, Sanderson SD, et al. Protein kinase C activation is required for cigarette smoke-enhanced C5a-mediated release of interleukin-8 in human bronchial epithelial cells. Am J Respir Cell Mol Biol 1999; 21: 283-288.
36. Zakrzewski JT, Barnes NC, Costello JF, et al. Lipid mediators in cystic fibrosis and chronic obstructive pulmonary disease. Am Rev Respir Dis 1987; 136: 779-782.
37. Yamamoto C, Yoneda T, Yoshikawa M, et al. Airway inflammation in COPD assessed by sputum levels of interleukine-8. Chest 1997; 112: 505-510.
38. Balbi B, Bason C, Balleari E, et al. Increased bronchoalveolar granulocytes and granulaocyte/macrophage colony-stimulating factor during exacerbations of chronic bronchitis. Eur Respir J 1997; 10: 846-850.
39. Vignola AM, Chanez P, Chiappara G, et al. Transforming growth factor-beta expression in mucosal biopsies in asthma and chronic bronchitis. Am J Respir Crit Care Med 1997; 156: 591-599.
40. Chalmers GW, Mocleod KJ, Sriram S, et al. Sputum endothelin-1 is increased in cystic fibrosis and chronic obstructive pulmonary disease [In process citation]. Eur Respir J 1999; 13: 1288-1292.
41. Drost EM, Selby C, Lannan S, et al. Changes in neutrophil deformability following in vitro smoke exposure: mechanism and protection. Am J Respir Cell Mol Biol 1992; 6: 287-295.
42. Robbins RA, Gossman GL, Nelson KJ, et al. Inactivation of chemotactic factor inactivator by cigarette smoke. A potential mechanism of modulating neutrophil recruitment to the lung. Am Rev Respir Dis 1990; 142: 763-768.
43. Janoff A. Reduction of the elastase in inhibitory capacity of alpha- 1-antitrypsin by peroxides in cigarette smoke. An analysis of the brands and the filters. Am Rev Respir Dis 1982; 126: 25-30.
44. Morrison HM, Welgus HG, Stockley RA, et al. Inhibition of human leukocyte elastase bound to elastin: relative ineffectiveness and two mechanisms of inhibitory activity. Am J Respir Cell Mol Biol 1994; 41: 442-447.
45. Shapiro SD. Matrix metalloproteinase degradation of extracellular matrix: biological consequences. Cur Opin Cell Biol 1998; 10: 602-608.
46. MacNee W, Wiggs B, Belzberg AS, et al. The effect of cigarette smoking on neutrophil kinetics in human lungs. N Engl J Med 1989; 321: 924-928.
47. MacElvaney NG, Crystal RG. Proteases and Lung Injury. Philadelphia, PA: Lippincott Raven, 1997.
48. Punchelle E, Zahm JM. Repair processes of the airway epithelium. In: Lenfant CL (ed.). Airways and Environments: From Injury to Repair: Lung Biology in Health and Disease. New York, NY: Marcel Dekker, 1996. 157-182.
49. Nakamura Y, Romberger DJ, Tate L, et al. Cigarette smoke inhibits lung fibroblast proliferation and chemotaxis. Am J Respir Crit Care Med 1995; 151: 1497-1503.
50. Osman M. Cigarette smoke impairs elastin resynthesis in lungs of hamsters with elastase-induced emphysema. Am Rev Respir Dis 1985; 132: 640-643.
51. Shoji S, Ertl RF, Linder J, et al. Bronchial epithelial cells produce chemotactic activity for bronchial epithelial cells: possible role for fibronection in airway repair. Am Rev Respir Dis 1990; 141: 218-225.
52. U.S. Surgeon General. The health consequences of smoking: chronic obstructive lung disease. U.S. Department of Health and Human Research, Vol. 84, 50 205
53. Buist AS, Vollmer WM. Smoking and other risk factors. In: Murray JF, Nadel JA, (eds). Textbook of Respiratory Medicine. Philadelphia, PA: W. B. Saunders, 1994. 1259-1287.
54. Siafakas NM, Vermeire P, Pride NB, et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD) Eur Respir J 1995; 8: 1398-1420.
55. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis 1987; 139: 225-244.
56. Leuenberger P, Schwartz J, Ackermann-Liebrich U, et al. Passive smoking exposure in adults and chronic respiratory symptoms (SAPALDIA Study). Am J Respir Crit Care Med 1994; 150: 1222-1228.
57. Dayal HH, Khuder S, Sharrar R, et al. Passive smoking in obstructive respiratory disease in an industrialized urban population. Environ Res 1994; 65: 161-171.
58. 1. Chest 1983; 83: 717-724.
59. Weiss ST. Early life predictors of adult chronic obstructive lung disease. Eur Respir Rev 1995; 5: 303-309.
60. Tager IB, Segal MR, Speizer FE, et al. The natural history of forced expiratory volumes: effect of cigarette smoking and respiratory symptoms. Am Rev Respir Dis 1988; 138: 837-849.
61. Sherrill DL, Lebowitz MID, Knudson RJ, et al. Smoking and symptom effects on the curves of lung function growth and decline. Am Rev Respir Dis 1991; 144: 17-22.
62. Burrows B, Knudson RJ, Lebowitz MD. The relationship of childhood respiratory illness to adult obstructive airway disease. Am Rev Respir Dis 1977; 115: 751-760.
63. Matsuse T, Hayashi S, Kuwano K, et al. Latent adenoviral infection in the pathogenesis of chronic airways obstruction. Am Rev Respir Dis 1992; 146: 177-184.
64. Keicho N, Elliott W, Hogg J, et al. Adenovirus EIA upregulates interleukin-8 expression induced by endotoxin in pulmonary epithelial cells. Am J Physiol 1997; 272: L1046-1052.
65. Vitalis TZ, Kern I, Croome A, et al. The effect of latent adenovirus 5 infection on cigarette smoke-induced lung inflammation. Eur Respir J 1998; 11: 664-669.
66. Fletcher C, Peto R. The natural history of chronic airflow obstruction. Br Med J 1977; 25; 1(6077): 1645-1648.
67. Kanner RE, Anthonisen NR, Cornett JE. The Lung Health Study Research Group. Lower respiratory illnesses promote FEV(1) decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease: results from the lung health study. Am J Respir Crit Care Med 2001; 1; 164(3): 358-364.
68. Shahar E, Folsom AR, Mlnick SL, et al. Dietary ω-3 polyunsaturated fatty acids and smoking-related chronic obstructive pulmonary disease: N Engl J Med 1994; 331: 228-233.
69. Sharp DS, Rodriguez BL, Shahar E, et al. Fish consumption may limit the damage of smoking on the lung. Am J Respir Crit Care Med 1994; 150: 983-987.
70. Miedema I, Feskens EJM, Heederik D, et al. Dietary determinants of long-term incidence of chronic nonspecific lung disease. The Zutphen study. Am J Epidemiol 1993; 138: 37-45.
71. Orie NG, Sluiter HJ, DeVries K, et al. The host factor in bronchitis. In: Orie NGM, Sluiter HJ (eds). Bronchitis: an International Symposium. Assen, Netherlands, 1961. 43-59.
72. Jeffery PK. Structural and inflammatory changes in COPD: a comparison with asthma. Thorax 1998; 53: 129-136.
73. Barter CE, Campbell AH. Relationship of constitutional factors and cigarette smoking to decrease in 1-second forced expiratory volume. Am Rev Respir Dis 1976; 113: 305-314.
74. Sparrow D, O'Connor G, Colton Th, et al. The relationship of nonspecific bronchial responsiveness to the occurrence of respiratory symptoms and decreased levels of pulmonary function. Am Rev Respir Dis 1987; 135: 1255-1260.
75. Parker DR, O'Connor GT, Sparrow D, et al. The relationship of nonspecific airway responsiveness and atopy to decline of lung function. Am Rev Respir Dis 1990; 141: 589-594.
76. Campbell AH, Barter CE, O'Connell JM, et al. Factors affecting the decline of ventilatory function in chronic bronchitis. Thorax 1985; 40: 741-748.
77. 1 decline in male working populations. Am Rev Respir Dis 1992; 146: 878-883.
78. 1; a longitudinal study in the elderly. Am J Respir Crit Care Med 1995; 151: 656-662.
79. 1. Am J Respir Crit Care Med 1995; 151: 1377-1382.
80. O'Connor GT, Sparrow D, Weiss ST. A prospective longitudinal study of methacholine airway responsiveness as a predictor of pulmonary-function decline: the normative aging study. Am J Respir Crit Care Med 1995; 152: 87-92.
81. Oswald NC, Harld JT, Martin WJ, Clinical pattern of chronic bronchitis. Lancet 1953; ii: 639-646.
82. Tager IB, Rosner B, Tishler PV, et al . Household aggregation of pulmonary function and chronic bronchitis. Am Rev Respir Dis 1976; 114: 485-492.
83. Sandford AJ, Weir TD, Pare PD. Genetic risk factors for chronic obstructive pulmonary disease. Eur Respir J 1997; 10: 1380-1391.
84. Black LF, Kueppers F. Alpha 1-antitrypsin deficiency in nonsmokers. Am Rev Respir Dis 1978; 117: 421-428.
85. Janus ED, Phillips NT, Carrell RW. Smoking, lung function and alpha 1-antitrypsin deficiency. Lancet 1985; i: 152-154.
86. Brantley ML, Paul LD, Miller BH, et al. Clinical features and history of the destructive lung disease associated with alpha 1-antitrypsin deficiency of adults with pulmonary symptoms. Am Rev Respir Dis 1988; 138: 327-336.
87. Tobin MJ, Cook PJL, Hutchinson DCS. Alphal-antitrypsin deficiency: the clinical and physiological features of pulmonary emphysema in subjects homozygous for Pi type Z: a survey by the British Thoracic Association. Br J Dis Chest 1983; 77: 14-27.
88. O'Brien ML, Buist NRM, Murphey HW. Neonatal screening for alpha 1-antitrypsin deficiency. J Pediatr 1978; 92: 1006-1010.
89. Tattersall SF, Pereira RP, Hunter D, et al. Lung distensibility and airway function in intermediate alpha1-antitrypsin deficiency. Thorax 1979; 34: 637-646.
90. Tarjan E, Magyar P, Vaczi Z, et al. Longitudinal lung function study in heterozygous PiMZ phenotype subjects. Eur Respir J 1994; 7: 2199-2204.
91. Owen MC, Brennan SO, Lewis JH, et al. Mutation of antitrypsin to antithrombin: a 1-antitrypsin Pittsburgh (358 met → arg), a fatal bleeding disorder. N Engl J Med 1983; 309: 694-698.
92. Kalsheker NA, Hodgson IJ, Watkins GL, et al. Deoxyribonucleic acid (DNA) polymorphism of the a 1-antitrypsin gene in Chronic lung disease. Br Med J 1987; 294: 1511-1514.
93. Poller W, Meison C, Olek K. DNA polymorphisms of the a 1-antitrypsin gene region in patients with chronic obstructive pulmonary disease. Eur J Clin Invest 1990; 20: 1-7.
94. Kalsheker NA, Watkins GL, Hill S, et al. Independent mutations in the flanking sequence of the alpha1-antitrypsin gene are associated with chronic obstructive airways disease. Dis Markers 1990; 8: 151-157.
95. Cruickshank AM, Hansell DT, Burns HJG, et al. Effect of nutritional status on acute phase protein response to elective surgery. Br J Surg 1989; 76: 165-168.
96. Eriksson S, Lindmark B, Liljia H. Familial a1-antichymotrypsin deficiency. Acta Med Scand 1986; 220: 447-453.
97. Poller W, Faber J-B, Scholz S, et al. Mis-sense mutation of a1-antichymotrypsin gene associated with chronic lung disease. Lancet 1992; 339: 1538.
98. Yamamoto N, Homma S. Vitamin D-binding protein (group-specific component) is a precursor for the macrophage-activating signal factor from lysophosphatidyl-choline-treated lymphocytes. Proc Natl Acad Sci USA 1991; 88: 8539-8543.
99. Kew RR, Webster RO. Gc-globulin (vitamin D-binding protein) enhances the neutrophil chemotactic aticity of C5a and C5a des Arg. J Clin Invest 1988; 82: 364-369.
100. Kueppers F, Miller RD, Gordon H, et al. Familial prevalence of chronic obstructive pulmonary disease in a matched pair study. Am J Med 1977; 63: 336-342.
101. Kauffmann F, Kleisbauer J-P, Cambon-de-Mouzon A, et al. Genetic markers in chronic airflow limitation: a genetic epidemiologic study. Am Rev Respir Dis 1983; 127: 263-269.
102. Poller W, Barth J, Voss B. Detection of an alteration of the a2-macroglobulin gene in a patient with chronic lung disease and serum a2-macroglobulin deficiency. Hum Genet 1989; 83: 93-96.
103. Webb DR, Condemi JJ. Selective immunoglobulin A deficiency and chronic obstructive lung disease. Ann Intern Med 1974; 80: 618-621.
104. Bjorkander J, Bake B, Oxelius VA, et al. Impaired lung function in patient with IgA deficiency and low levels of IgG2 or IgG3. N Engl J Med 1985; 313: 720-724.
105. O'Keefe S, Gzel A, Drury R, et al. Immunoglobulin G subclasses and spirometry in patients with chronic obstructive pulmonary disease. Eur Respr J 1991; 4: 932-938.
106. Sandstrom J, Nilsson P, Karlsson K, et al. Tenfold increase in human plasma extracellular superoxide dismutase contest caused by a mutation in heparin-binding domain. J Biol Chem 1994; 268: 19 163-19 166.
107. Sallenave J-M, Shulmann J, Crossley J, et al. Regulation of secretory leukocyte proteinase inhibitor (SLPI) and elastase-specific inhibitor (ESI/Elafin) in human airway epithelial airway cells by cytokines and neutrophilic enzymes. Am J Respir Cell Mol Biol 1994; 11: 733-741.
108. Abe T, Kobayashi N, Yoshimura K, et al. Expression of the secretory leukoprotease inhibitor gene in epithelial cells. J Clin Invest 1991; 87: 2207-2215.
109. Ludecke B, Poller W, Olek K, et al. Sequence variant of the human cathepsin G gene. Hum Genet 1993; 91: 83-84.
110. Smith CA, Harrison DJ. Association between polymorphism in gene for microsomal epoxide hydrolase and susceptibility to emphysema. Lancet 1997; 350: 630-633.
111. Harrison DJ, Canthlay AM, Rae F, et al. Frequency of glutathione S-transferase MI deletion in smokers with emphysema and lung cancer. Hum Exp Toxicol 1997; 16: 356-360.
112. Cohen BH, Ball WC, Brashears S, et al. Risk factors in chronic obstructive pulmonary disease (COPD). Am J Epidemiol 1977; 105: 223-232.
113. Higgins MW, Keller JB, Becker M, et al. An index of risk for obstructive airways disease. Am Rev Respir Dis 1982; 125: 144-151.
114. Vestbo J, Hein HO, Suadicani P, et al. Genetic markers for chronic bronchitis and peck expiratory flow in the Copenhagen male study. Dan Med Bull 1993; 40: 378-380.
115. Cohen BH, Bias WB, Chase GA, et al. Is ABH non-secretor status a risk factor for obstructive lung disease? Am J Epidemiol 1980; 111: 285-291.
116. Abboud RT, Yu P, Chan-Yeung M, et al. Lack of relationship between ABH secretor status and lung function in pulp-mill workers. Am Rev Respir Dis 1982; 126: 1089-1091.
117. Horne SL, Cockcroft DW, Lovegrove A, et al. ABO, Lewis and secretor status and relative incidence of airflow obstruction. Dis Markers 1985; 3: 55-62.
118. Cantlay AM, Lamb D, Gillooly M, et al. Association between the CYPIA1 gene polymorphism and susceptibility to emphysema and lung cancer. J Clin Pathol: Mol Pathol 1995; 48: M210-214.
119. Entzian P, Muller E, Boysen A, et al. Frequency of common cystic fibrosis gene mutations in chronic bronchitis patients. Scand J Lab Invest 1995; 55: 263-266.
120. Charlesworth B, Sniegowski P, Stephan W. The evolutionary dynamics of repetitive DNA in eukaryotes. Nature 1994; 371: 215-220.
121. Spandidos DA, Ergazaki M, Hatzistamou J, et al. Microsatellite instability in patients with chronic obstructive pulmonary disease. Oncol Rep 1996; 3: 489-491.
122. Siafakas NM, Tzortzaki EG, Sourvinos G, et al. Microsatellite DNA instability in COPD. Chest 1999; 116: 47-51.
123. Barnes PJ. Genetics and pulmonary medicine. 9 Molecular genetics of chronic obstructive pulmonary disease. Thorax 1999; 54: 245-252.
124. Barnes PJ. chronic obstructive pulmonary disease. N Engl J Med 2000; 343: 269-280.