About half of all cases of chronic obstructive pulmonary disease (COPD) are due to non-smoking-related risk factors, which vary by geographical region. These factors include premature birth, childhood respiratory infections, poorly controlled asthma, history of tuberculosis, indoor and outdoor air pollution, and occupational exposures. Understanding the roles of genetic and environmental factors in the development of COPD could allow early intervention or improved strategies for prevention.
In the first of a Series of three papers on the origins of COPD, Michael Cho and colleagues provide a comprehensive review of the genetics of COPD. Ian Yang and colleagues focus on risk factors and disease pathogenesis in never-smokers, considering opportunities for risk modification to reduce the burden of COPD globally. Finally, Rosa Faner and colleagues discuss gene–environment interactions across the lifespan and propose that integration of the time axis in models of COPD pathogenesis will be key to progress in research and clinical practice.