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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Kazan medical journal</journal-id><journal-title-group><journal-title xml:lang="en">Kazan medical journal</journal-title><trans-title-group xml:lang="ru"><trans-title>Казанский медицинский журнал</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0368-4814</issn><issn publication-format="electronic">2587-9359</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">678486</article-id><article-id pub-id-type="doi">10.17816/KMJ678486</article-id><article-id pub-id-type="edn">DGXKHK</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Unresolved issues in chronic obstructive pulmonary disease: perspectives in genetic research</article-title><trans-title-group xml:lang="ru"><trans-title>Нерешённые вопросы хронической обструктивной болезни лёгких: перспективы генетических исследований</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>慢性阻塞性肺病尚未解决的问题：遗传研究的前景</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8821-0421</contrib-id><contrib-id contrib-id-type="spin">5362-0356</contrib-id><name-alternatives><name xml:lang="en"><surname>Khamitov</surname><given-names>Rustem F.</given-names></name><name xml:lang="ru"><surname>Хамитов</surname><given-names>Рустэм Фидагиевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor, Head, Depart. of Internal Diseases</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор, заведующий, каф. внутренних болезней</p></bio><email>rhamitov@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-1157-0984</contrib-id><contrib-id contrib-id-type="spin">8579-1605</contrib-id><name-alternatives><name xml:lang="en"><surname>Sattarova</surname><given-names>Firyuza I.</given-names></name><name xml:lang="ru"><surname>Саттарова</surname><given-names>Фирюза Ильдаровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Assistant Lecturer, Depart. of Internal Diseases</p></bio><bio xml:lang="ru"><p>ассистент, каф. внутренних болезней</p></bio><email>fifuza@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6210-4660</contrib-id><contrib-id contrib-id-type="spin">8706-8630</contrib-id><name-alternatives><name xml:lang="en"><surname>Egorova</surname><given-names>Emiliya S.</given-names></name><name xml:lang="ru"><surname>Егорова</surname><given-names>Эмилия Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Junior Research Associate, Lab. of Genetics of Aging and Longevity, Central Research Laboratory</p></bio><bio xml:lang="ru"><p>младший научный сотрудник; лаб. генетики старения и долголетия Центральной научно-исследовательской лаборатории</p></bio><email>jastspring@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Kazan State Medical University</institution></aff><aff><institution xml:lang="ru">Казанский государственный медицинский университет</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-07-25" publication-format="electronic"><day>25</day><month>07</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-08-05" publication-format="electronic"><day>05</day><month>08</month><year>2025</year></pub-date><volume>106</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>578</fpage><lpage>589</lpage><history><date date-type="received" iso-8601-date="2025-04-12"><day>12</day><month>04</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-06-02"><day>02</day><month>06</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2025,</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2028-08-05"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0/</ali:license_ref></license></permissions><self-uri xlink:href="https://kazanmedjournal.ru/kazanmedj/article/view/678486">https://kazanmedjournal.ru/kazanmedj/article/view/678486</self-uri><abstract xml:lang="en"><p>The global prevalence of chronic obstructive pulmonary disease among individuals aged &gt;40 years is approximately 10%. The disease’s progression, often leading to early disability, underscores its significant medical and social impact. Further research of risk factors, particularly genetic underpinnings, of chronic obstructive pulmonary disease is essential for developing effective primary prevention strategies in genetically predisposed individuals. This review aimed to analyze international and Russian scientific sources on genetic polymorphisms associated with chronic obstructive pulmonary disease and their roles in disease pathogenesis and examine the pharmacogenetic aspects of therapy, specifically how genetic variation affects drug efficacy and safety. Full-text articles published between 2000 and 2024 and indexed in <italic>PubMed</italic>, <italic>eLIBRARY.RU</italic>, <italic>Google Scholar</italic>, and <italic>ResearchGate</italic><italic> </italic>were analyzed. This review summarizes key genetic studies on chronic obstructive pulmonary disease, including comorbidities and pharmacogenetic characteristics of commonly used drugs. Research on heritable factors confirmed that genetic susceptibility increases the risk of chronic obstructive pulmonary disease. Several variables influence therapeutic response, among which genetic factors are critical for guiding treatment choices. Large-scale genome-wide association studies have identified chronic obstructive pulmonary disease-associated loci that contribute to our understanding of disease pathogenesis. Polygenic risk scores based on multiple single-nucleotide polymorphisms have demonstrated efficacy in predicting disease risk and severity and may be useful in predictive medicine. The investigation of genetic polymorphisms offers promising opportunities for the advancement of personalized approaches to the prediction, prevention, and treatment of chronic obstructive pulmonary disease.</p></abstract><trans-abstract xml:lang="ru"><p>Распространённость хронической обструктивной болезни лёгких в мире среди лиц старше 40 лет составляет около 10%. Наряду с этим неуклонное прогрессирование заболевания, приводящее к ранней инвалидизации, определяет высокую медико-социальную значимость заболевания. Требуется дальнейшее изучение факторов риска, включая генетические особенности хронической обструктивной болезни лёгких, с целью разработки эффективной первичной профилактики среди предрасположенных лиц. Целью нашего исследования явился обзор зарубежной и отечественной научной медицинской литературы, посвящённой генетическим полиморфизмам, ассоциированным с хронической обструктивной болезнью лёгких, и их роли в патогенезе заболевания, а также анализ фармакогенетических аспектов терапии — влияние генетических полиморфизмов на эффективность и безопасность лекарственных препаратов. Проанализированы полнотекстовые публикации за период с 2000 по 2024 год, размещённые в базах данных PubMed, eLibrary.Ru, Google Scholar, ResearchGate. Представлен анализ наиболее важных генетических исследований хронической обструктивной болезни лёгких, включая данные о сочетании заболевания с коморбидными состояниями и особенностях фармакогенетики препаратов. Исследования, посвящённые наследственным факторам, убедительно подтверждают, что генетическая предрасположенность существенно повышает риск развития заболевания. Реакция на лекарственные препараты зависит от множества факторов, среди которых важную роль играют генетические особенности, определяющие выбор терапии. Полногеномные исследования ассоциаций в крупных выборках пациентов позволяют выявить достоверно связанные с заболеванием локусы и играют важную роль в уточнении патогенеза. Шкалы генетического риска, строящиеся на основе объединения эффектов нескольких однонуклеотидных полиморфизмов, показали свою эффективность в прогнозировании риска и тяжести хронической обструктивной болезни лёгких. В дальнейшем такие шкалы могут иметь клиническое значение в рамках предиктивной медицины. Изучение генетических полиморфизмов открывает перспективы для разработки персонализированных медицинских подходов к прогнозированию, профилактике и лечению хронической обструктивной болезни лёгких.</p></trans-abstract><trans-abstract xml:lang="zh"><p>世界上40岁以上人群中慢性阻塞性肺病的患病率约为10％。与此同时，疾病的稳定进展，导致早期残疾，决定了该疾病的高度医疗和社会意义。需要进一步研究危险因素，包括慢性阻塞性肺病的遗传特征，以便在易感性个体中发展有效的初级预防。本研究的目的是回顾国内外有关慢性阻塞性肺病遗传多态性及其在疾病发病机制中的作用的科学医学文献，并分析治疗的药物遗传学方面—遗传多态性对药物有效性和安全性的影响。在PubMed、eLibrary.Ru、Google Scholar、ResearchGate数据库中托管的2000年至2024年期间的全文出版物是。介绍了对慢性阻塞性肺病最重要的遗传研究的分析，包括该疾病与合并症条件的组合以及药物的药物遗传学的数据。对遗传因素的研究强烈证实，遗传易感性显着增加了患该疾病的风险。对药物的反应取决于许多因素，其中遗传特征在决定治疗选择方面起着重要作用。大患者样本中的全基因组关联研究使得能够鉴定可靠的疾病相关基因座，并在阐明发病机制中发挥重要作用。基于结合几种单核苷酸多态性的影响的遗传风险量表已经显示出它们在预测慢性阻塞性肺病的风险和严重程度方面的有效性。未来，此类量表可能在预测医学中具有临床意义。遗传多态性的研究开辟了发展个性化医疗方法的前景，以预后，预防和治疗慢性阻塞性肺病。</p></trans-abstract><kwd-group xml:lang="en"><kwd>review</kwd><kwd>chronic obstructive pulmonary disease</kwd><kwd>comorbidity</kwd><kwd>genetic polymorphisms</kwd><kwd>genome-wide association studies</kwd><kwd>pharmacogenetics</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>обзор</kwd><kwd>хроническая обструктивная болезнь лёгких</kwd><kwd>коморбидность</kwd><kwd>генетические полиморфизмы</kwd><kwd>полногеномные исследования</kwd><kwd>фармакогенетика препаратов</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>综述</kwd><kwd>慢性阻塞性肺病</kwd><kwd>合并症</kwd><kwd>遗传多态性</kwd><kwd>全基因组研究</kwd><kwd>药物药物遗传学</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Agusti A, Celli BR, Criner GJ, et al. 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