Unresolved Issues in Chronic Obstructive Pulmonary Disease: Perspectives in Genetic Research
- Authors: Khamitov R.F.1, Sattarova F.I.1, Egorova E.S.1
-
Affiliations:
- Kazan State Medical University
- Section: Reviews
- Submitted: 12.04.2025
- Accepted: 02.06.2025
- Published: 25.07.2025
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/678486
- DOI: https://doi.org/10.17816/KMJ678486
- EDN: https://elibrary.ru/DGXKHK
- ID: 678486
Cite item
Abstract
The global prevalence of chronic obstructive pulmonary disease among individuals aged >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 PubMed, eLIBRARY.RU, Google Scholar, and ResearchGate 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.
About the authors
Rustem F. Khamitov
Kazan State Medical University
Email: rhamitov@mail.ru
ORCID iD: 0000-0001-8821-0421
SPIN-code: 5362-0356
MD, Dr. Sci. (Medicine), Professor, Head, Depart. of Internal Diseases
Russian Federation, KazanFiryuza I. Sattarova
Kazan State Medical University
Author for correspondence.
Email: fifuza@mail.ru
ORCID iD: 0009-0002-1157-0984
SPIN-code: 8579-1605
Assistant Lecturer, Depart. of Internal Diseases
Russian Federation, KazanEmiliya S. Egorova
Kazan State Medical University
Email: jastspring@yandex.ru
ORCID iD: 0000-0002-6210-4660
SPIN-code: 8706-8630
Junior Research Associate, Lab. of Genetics of Aging and Longevity, Central Research Laboratory
Russian Federation, KazanReferences
- Agusti A, Celli BR, Criner GJ, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Eur Respir J. 2023;61(4):2300239. doi: 10.1183/13993003.00239-2023 EDN: INNNID
- Al Wachami N, Guennouni M, Iderdar Y, et al. Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis. BMC Public Health. 2024;24(1):297. doi: 10.1186/s12889-024-17686-9 EDN: ZCCRJA
- Avdeev SN, Leshchenko IV, Aisanov ZR. Chronic obstructive pulmonary disease (COPD 2024). Clinical guidelines (short version). Journal of Respiratory Medicine. 2025;1(2):5–16. doi: 10.17116/respmed202510215
- Bhatt SP, Casaburi R, Agustí À, et al. Chronic obstructive pulmonary disease: hiding in plain sight, a Statement from the COPD Foundation Medical and Scientific Advisory Committee. Lancet Respir Med. 2023;11(12):1041–1043. doi: 10.1016/s2213-2600(23)00436-8
- Celli BR, Fabbri LM, Aaron SD, et al. An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. Am J Respir Crit Care Med. 2021;204(11):1251–1258. doi: 10.1164/rccm.202108-1819PP EDN: GPOTVG
- Abdullaeva NM, Fesenko OV, Belousov AS, et al. Epidemiology and Pathogenesis of Pathology Associated with Chronic Obstructive Pulmonary Disease. Effective pharmacotherapy. 2024;20(16):63–67. doi: 10.33978/2307-3586-2024-20-16-63-67 EDN: LSGWAI
- Chen H, Luo X, Du Y, et al. Association between chronic obstructive pulmonary disease and cardiovascular disease in adults aged 40 years and above: data from NHANES 2013–2018. BMC pulmonary medicine. 2023;23(1):318. doi: 10.1186/s12890-023-02606-1 EDN: MZRCIY
- Voulgaris A, Archontogeorgis K, Steiropoulos P, Papanas N. Cardiovascular Disease in Patients with Chronic Obstructive Pulmonary Disease, Obstructive Sleep Apnoea Syndrome and Overlap Syndrome. Current vascular pharmacology. 2021;19(3):285–300. doi: 10.2174/1570161118666200318103553 EDN: JBZGZI
- Rogliani P, Ritondo BL, Laitano R, et al. Advances in understanding of mechanisms related to increased cardiovascular risk in COPD. Exp Rev Respirat Med. 2021;15(1):59–70. doi: 10.1080/17476348.2021.1840982 EDN: KXGKVF
- Balbirsingh V, Mohammed AS, Turner AM, Newnham M. Cardiovascular disease in chronic obstructive pulmonary disease: a narrative review. Thorax. 2022:thoraxjnl-2021-218333. doi: 10.1136/thoraxjnl-2021-218333 EDN: UFARUB
- Papaporfyriou A, Bartziokas K, Gompelmann D, et al. Cardiovascular Diseases in COPD: From Diagnosis and Prevalence to Therapy. Life. 2023;13(6):1299. doi: 10.3390/life13061299 EDN: OSSIDA
- Martinez-Garcia MÁ, Faner R, Oscullo G, et al. Chronic bronchial infection and incident cardiovascular events in chronic obstructive pulmonary disease patients: A long-term observational study. Respirology. 2021;26(8):776–785. doi: 10.1111/resp.14086 EDN: CYVWUL
- Anthonisen NR, Connett JE, Enright PL, Manfreda J; Lung Health Study Research Group. Hospitalizations and mortality in the Lung Health Study. Am J Respirat Crit Care Med. 2002;166(3):333–339. doi: 10.1164/rccm.2110093
- Zhou JJ, Cho MH, Castaldi PJ, et al. Heritability of chronic obstructive pulmonary disease and related phenotypes in smokers. Am J Respirat Crit Care Med. 2013;188(8):941–947. doi: 10.1164/rccm.201302-0263OC
- Silverman EK. Genetics of COPD. Annual review of physiology. 2020;82:413–431. doi: 10.1146/annurev-physiol-021317-121224 EDN: XGTMZD
- Cho MH, Hobbs BD, Silverman EK. Genetics of chronic obstructive pulmonary disease: understanding the pathobiology and heterogeneity of a complex disorder. Lancet Respir Med. 2022;10(5):485–496. doi: 10.1016/S2213-2600(21)00510-5 EDN: YCQOON
- Dasí F. Alpha-1 antitrypsin deficiency. Medicina clinica. 2024;162(7):336–342. doi: 10.1016/j.medcli.2023.10.014 EDN: KQXTKH
- Larshina EA, Milovanova NV, Kamenets EA. Alpha-1-antitrypsin deficiency: diagnosis and treatment (literature review). Medical genetics. 2021;20(1):12–24. doi: 10.25557/2073-7998.2021.01.12-24 EDN: UIUUUF
- Pillai SG, Ge D, Zhu G, et al. A genome-wide association study in chronic obstructive pulmonary disease (COPD): identification of two major susceptibility loci. PLoS Genetics. 2009;5(3):e1000421. doi: 10.1371/journal.pgen.1000421 EDN: MNEZBJ
- Sakornsakolpat P, Prokopenko D, Lamontagne M, et al. Genetic landscape of chronic obstructive pulmonary disease identifies heterogeneous cell-type and phenotype associations. Nat Gen. 2019;51(3):494–505. doi: 10.1038/s41588-018-0342-2 EDN: WQQNCY
- Hobbs BD, de Jong K, Lamontagne M, et al. Genetic loci associated with chronic obstructive pulmonary disease overlap with loci for lung function and pulmonary fibrosis. Nat Gen. 2017;49(3):426–432. doi: 10.1038/ng.3752 EDN: YXPCKP
- Hobbs BD, Parker MM, Chen H, et al. Exome Array Analysis Identifies a Common Variant in IL27 Associated with Chronic Obstructive Pulmonary Disease. Am J Respirat Crit Care Med. 2016;194(1):48–57. doi: 10.1164/rccm.201510-2053OC EDN: XTSQQH
- Chen G, Jin Y, Chu C, et al. A cross-tissue transcriptome-wide association study reveals GRK4 as a novel susceptibility gene for COPD. Sci Rep. 2024;14(1):28438. doi: 10.1038/s41598-024-80122-w EDN: QALGSM
- Wang M, Zhang Y, Xu M, et al. Roles of TRPA1 and TRPV1 in cigarette smoke -induced airway epithelial cell injury model. Free Radic Biol Med. 2019;134:229–238. doi: 10.1016/j.freeradbiomed.2019.01.004 EDN: RTSZTE
- Kuvaeva EE, Mertsalov IB, Simonova OB. Transient receptor potential (TRP) family of channel proteins. Russian Journal of Developmental Biology. 2022;53(5):309–320. doi: 10.31857/S0475145022050044 EDN: XFJJUC
- Kim W, Prokopenko D, Sakornsakolpat P, et al. Genome-Wide Gene-by-Smoking Interaction Study of Chronic Obstructive Pulmonary Disease. Am J Epidemiol. 2021;190(5):875–885. doi: 10.1093/aje/kwaa227 EDN: NNPEEQ
- Hopkins RJ, Duan F, Gamble GD, et al. Chr15q25 genetic variant (rs16969968) independently confers risk of lung cancer, COPD and smoking intensity in a prospective study of high-risk smokers. Thorax. 2021;76(3):272–280. doi: 10.1136/thoraxjnl-2020-214839 EDN: MDMMOF
- Lee YJ, Choi S, Kwon SY, et al. A Genome-Wide Association Study in Early COPD: Identification of One Major Susceptibility Loci. Int J Chron Obstruct Pulmon Dis. 2020;15:2967–2975. doi: 10.2147/COPD.S269263
- Cho MH, Hobbs BD, Silverman EK. Genetics of chronic obstructive pulmonary disease: understanding the pathobiology and heterogeneity of a complex disorder. Lancet Respir Med. 2022;10(5):485–496. doi: 10.1016/S2213-2600(21)00510-5 EDN: YCQOON
- Zhang J, Hobbs BD, Silverman EK, et al. Polygenic Risk Score Added to Conventional Case Finding to Identify Undiagnosed Chronic Obstructive Pulmonary Disease. JAMA. 2025;333(9):784–792. doi: 10.1001/jama.2024.24212 EDN: ZUELIQ
- Zhang J, Xu H, Qiao D, et al. A polygenic risk score and age of diagnosis of COPD. Eur Respir J. 2022;60(3):2101954. doi: 10.1183/13993003.01954-2021 EDN: PIQEUW
- Li N, Li X, Liu M, et al. Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data. BMC Pulmon Med. 2023;23(1):481. doi: 10.1186/s12890-023-02771-3 EDN: UJXYCZ
- Joo J, Himes B. Gene-Based Analysis Reveals Sex-Specific Genetic Risk Factors of COPD. AMIA Annual Symposium proceedings. AMIA Annu Symp Proc. 2022;2021:601–610. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8861659/
- Hardin M, Cho MH, Sharma S, et al. Sex-Based Genetic Association Study Identifies CELSR1 as a Possible Chronic Obstructive Pulmonary Disease Risk Locus among Women. Am J Respir Cell Mol Biol. 2017;56(3):332–341. doi: 10.1165/rcmb.2016-0172OC EDN: YXPBTR
- Xu L, Bian W, Gu XH, Shen C. Genetic polymorphism in matrix metalloproteinase-9 and transforming growth factor-β1 and susceptibility to combined pulmonary fibrosis and emphysema in a Chinese population. Kaohsiung J Med Sci. 2017;33(3):124–129. doi: 10.1016/j.kjms.2016.12.004
- Wain LV, Shrine N, Artigas MS, et al. Genome-wide association analyses for lung function and chronic obstructive pulmonary disease identify new loci and potential druggable targets. Nat Gen. 2017;49(3):416–425. doi: 10.1038/ng.3787 EDN: YXQWLD
- Vegas-Sánchez-Ferrero G, José Estépar RS. Statistical Framework for the Definition of Emphysema in CT Scans: Beyond Density Mask. Med Image Comput Comput Assist Interv. 2018;11071:821–829. doi: 10.1007/978-3-030-00934-2_91
- Manichaikul A, Hoffman EA, Smolonska J, et al. Genome-wide study of percent emphysema on computed tomography in the general population. The Multi-Ethnic Study of Atherosclerosis Lung/SNP Health Association Resource Study. Am J Respir Crit Care Med. 2014;189(4):408–418. doi: 10.1164/rccm.201306-1061OC EDN: SRIKUL
- Cho MH, Castaldi PJ, Hersh CP, et al. A Genome-Wide Association Study of Emphysema and Airway Quantitative Imaging Phenotypes. Am J Respir Crit Care Med. 2015;192(5):559–569. doi: 10.1164/rccm.201501-0148OC
- Zhu Z, Wang X, Li X, et al. Genetic overlap of chronic obstructive pulmonary disease and cardiovascular disease-related traits: a large-scale genome-wide cross-trait analysis. Respir Res. 2019;20(1):64. doi: 10.1186/s12931-019-1036-8 EDN: QTQKVO
- Axson EL, Bottle A, Cowie MR, Quint JK. Relationship between heart failure and the risk of acute exacerbation of COPD. Thorax. 2021;76(8):807–814. doi: 10.1136/thoraxjnl-2020-216390 EDN: XLCFEC
- Güder G, Rutten FH. Comorbidity of heart failure and chronic obstructive pulmonary disease: more than coincidence. Curr Heart Fail Rep. 2014;11(3):337–346. doi: 10.1007/s11897-014-0212-x EDN: QQQNRH
- Jiang R, Sun C, Yang Y, et al. Causal relationship between chronic obstructive pulmonary disease and heart failure: A Mendelian randomization study. Heart Lung. 2024;67:12–18. doi: 10.1016/j.hrtlng.2024.04.007 EDN: YRXATG
- Uffelmann E, Huang QQ, Munung NS, et al. Genome-wide association studies. Nature reviews methods primers. 2021;1:1–21. doi: 10.1038/s43586-021-00056-9
- Kim S, Oesterreich S, Kim S, et al. Integrative clustering of multi-level omics data for disease subtype discovery using sequential double regularization. Biostatistics. 2017;18(1):165–179. doi: 10.1093/biostatistics/kxw039
- Barnes PJ. Oxidative stress-based therapeutics in COPD. Redox biology. 2020;33:101544. doi: 10.1016/j.redox.2020.101544 EDN: LYMAMX
- Morrow JD, Qiu W, Chhabra D, et al. Identifying a gene expression signature of frequent COPD exacerbations in peripheral blood using network methods. BMC Med Genomics. 2015;8:1. doi: 10.1186/s12920-014-0072-y EDN: ZYNEQB
- Aggarwal T, Wadhwa R, Thapliyal N, et al. Oxidative, inflammatory, genetic, and epigenetic biomarkers associated with chronic obstructive pulmonary disorder. J Cell Physiol. 2019;234(3):2067–2082. doi: 10.1002/jcp.27181
- Wang R, Xu J, Liu H, Zhao Z. Peripheral leukocyte microRNAs as novel biomarkers for COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:1101–1112. doi: 10.2147/COPD.S130416
- Zhang Z, Wang J, Li Y, et al. Proteomics and metabolomics profiling reveal panels of circulating diagnostic biomarkers and molecular subtypes in stable COPD. Respir Res. 2023;24(1):73. doi: 10.1186/s12931-023-02349-x EDN: DTAEKJ
- Dickson RP, Martinez FJ, Huffnagle GB. The role of the microbiome in exacerbations of chronic lung diseases. Lancet. 2014;384(9944):691–702. doi: 10.1016/S0140-6736(14)61136-3
- Budden KF, Shukla SD, Rehman SF, et al. Functional effects of the microbiota in chronic respiratory disease. The Lancet. Respir Med. 2019;7(10):907–920. doi: 10.1016/S2213-2600(18)30510-1 EDN: YULISS
- Wang Z, Yang Y, Yan Z, et al. Multi-omic meta-analysis identifies functional signatures of airway microbiome in chronic obstructive pulmonary disease. ISME J. 2020;14(11):2748–2765. doi: EDN: PGUJKC
- Hardin M, Cho MH, McDonald ML, et al. A genome-wide analysis of the response to inhaled β2-agonists in chronic obstructive pulmonary disease. The Pharmacogenomics Journal. 2016;16(4):326–335. doi: 10.1038/tpj.2015.65
- Matera MG, Rogliani P, Novelli G, Cazzola M. The impact of genomic variants on patient response to inhaled bronchodilators: a comprehensive update. Expert Opin Drug Metab Toxicol. 2023;19(5):285–295. doi: 10.1080/17425255.2023.2221848 EDN: UXJPBO
- Celli BR, Christenson S, Rabe KF, et al. Current Smoker: A Clinical COPD Phenotype Affecting Disease Progression and Response to Therapy. Am J Respir Crit Care Med. 2025;211(5):729–736. doi: 10.1164/rccm.202407-1379CI
- Taylor DR, Drazen JM, Herbison GP, et al. Asthma exacerbations during long term beta agonist use: influence of beta (2) adrenoceptor polymorphism. Thorax. 2000;55(9):762–767. doi: 10.1136/thorax.55.9.762
- Lima JJ. Do genetic polymorphisms alter patient response to inhaled bronchodilators? Exp Opin Drug Metabol Toxicol. 2014;10(9):1231–1240. doi: 10.1517/17425255.2014.939956
- Mustafina MKh, Tsvetkova OA. Pharmacogenetic effect of ADRB2 gene polymorphism on therapeutic response in chronic obstructive pulmonary disease. Pulmonologiya. 2013;(3):21–24. doi: 10.18093/0869-0189-2013-0-3-21-24 EDN: RBJUHP
- Kim WJ, Hersh CP, DeMeo DL, et al. Genetic association analysis of COPD candidate genes with bronchodilator responsiveness. Respirat Med. 2009;103(4):552–557. doi: 10.1016/j.rmed.2008.10.025
- Kehinde O, Ramsey LB, Gaedigk A, Oni-Orisan A. Advancing CYP2D6 Pharmacogenetics through a Pharmacoequity Lens. Clin Pharmacol Therap. 2023;114(1):69–76. doi: 10.1002/cpt.2890 EDN: EARWIK
- Obeidat M, Faiz A, Li X, et al. The pharmacogenomics of inhaled corticosteroids and lung function decline in COPD. Eur Respirat J. 2019;54(6):1900521. doi: 10.1183/13993003.00521-2019
- Russo P, Tomino C, Santoro A, et al. FKBP5 rs4713916: A Potential Genetic Predictor of Interindividual Different Response to Inhaled Corticosteroids in Patients with Chronic Obstructive Pulmonary Disease in a Real-Life Setting. Int J Mol Sci. 2019;20(8):2024. doi: 10.3390/ijms20082024
- Marcolongo F, Scarlata S, Tomino C, et al. Psycho-cognitive assessment and quality of life in older adults with chronic obstructive pulmonary disease-carrying the rs4713916 gene polymorphism (G/A) of gene FKBP5 and response to pulmonary rehabilitation: a proof of concept study. Psychiatr genet. 2022;32(3):116–124. doi: 10.1097/YPG.0000000000000308 EDN: JVANWC
- Lei Y, Gao Y, Chen J, et al. GLCCI1 rs37973: a potential genetic predictor of therapeutic response to inhaled corticosteroids in Chinese chronic obstructive pulmonary disease patients. Sci Rep. 2017;7:42552. doi: 10.1038/srep42552 EDN: YXHFPZ
- Xiong S, Li L. The effect of CYP1A2 gene polymorphism on the metabolism of theophylline. Exp Ther Med. 2018;15(1):109–114. doi: 10.3892/etm.2017.5396 EDN: YKLWQJ
- Trushenko NV, Lavginova ВВ, Belkina OS, Avdeev SN. Targeted therapy as a new perspective in the treatment of COPD. Meditsinskiy Sovet. 2024;18(20):10–16. doi: 10.21518/ms2024-519 EDN: EKLCZI
- Singh D, Higham A, Beech A. The relevance of eosinophils in chronic obstructive pulmonary disease: inflammation, microbiome and clinical outcomes. J Leukoc Biol. 2024;116(5):927–946. doi: 10.1093/jleuko/qiae153 EDN: DYQQDW
- Rabe KF, Martinez FJ, Bhatt SP, et al. AERIFY-1/2: two phase 3, randomised, controlled trials of itepekimab in former smokers with moderate-to-severe COPD. ERJ Open Research. 2024;10(5):00718–2023. doi: 10.1183/23120541.00718-2023
Supplementary files
