Bronchodilator responsiveness has been associated with a subsequent accelerated decline in forced expiratory volume in one second (FEV1). Therefore, bronchodilator responsiveness and total serum immunoglobulin E(IgE) levels were assessed in 184 adult first-degree relatives of probands with severe early-onset chronic obstructive pulmonary disease (COPD) and a control group.Greater bronchodilator responsiveness was found among current smokers or exsmokers who were first-degree relatives of early-onset COPD probands than in currently or exsmoking controls, expressed as increase in FEV1 as a percentage of baseline (5.88.1 versus 2.95.1%, p<0.01), absolute increase in FEV1 from baseline (120130 versus 60110 mL, p<0.05), and increase in FEV1 as a percentage of the predicted value (3.64.1 versus 2.23.9%, p<0.05). However, elevated total serum IgE levels were not found in first-degree relatives of early-onset COPD probands compared with control subjects.The increased bronchodilator responsiveness among currently smoking/exsmoking first-degree relatives of early-onset COPD probands suggests that these individuals may have enhanced susceptibility to the detrimental effects of cigarette smoking. Eur Respir J 1999; 14: 1009±1014. Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the USA [1, 2] and a growing international problem, is strongly associated with cigarette smoking [3]. Even though tobacco use is a well-known risk factor for COPD [4], the development of airflow obstruction in response to smoking is highly variable [5], and it has been postulated that individuals may vary in their genetic susceptibility to COPD [3]. In a previous report on individuals without severe a 1 -antitrypsin deficiency, increased risk of airflow obstruction and chronic bronchitis was found in current smokers and exsmokers who were first-degree relatives of probands with severe early-onset COPD, compared with appropriate control subjects [6]. Thus, the findings of the authors and others [7±13] suggest that familial factors, probably genetic, contribute to the development of COPD.Bronchodilator responsiveness, a physiological response that differs from airway responsiveness to bronchoconstrictors, has been associated with a subsequent accelerated decline in forced expiratory volume in one second (FEV1) [14±17]. Thus, bronchodilator responsiveness may be associated with an increased risk of either acquiring COPD or developing the disease at an earlier age in susceptible individuals who smoke.Higher total serum immunoglobulin E (IgE) levels have previously been demonstrated in first degree relatives of PI Z subjects with COPD than in first-degree relatives of PI Z subjects without COPD [18]. This report presents a comparison of bronchodilator responsiveness and total serum IgE levels in 184 adult first-degree relatives of 44 probands with severe early-onset COPD (without severe a 1 -antitrypsin deficiency) and 83 adult control subjects.
Methods
Study participantsThe screening and enrolment procedures ...
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