We wanted an easy way to tell who might be at high risk of developing chronic obstructive pulmonary disease (COPD). COPD is very common globally, but lung damage often starts quietly, long before anyone feels unwell. We followed thousands of high-risk people in China for 2 years using pulmonary function tests and then confirmed our findings using a large United Kingdom general population group studied over a longer period.

The pulmonary function test we used checked 2 key things: how fast you can breathe out or exhale air (forced expiratory volume in 1 second [FEV]) and how much total air you can push out (forced vital capacity [FVC]). The FEV₁ to FVC ratio is a key way of evaluating airway obstruction. We discovered that people with a “borderline ratio” –between normal lung function and abnormal lung function—were far more likely to develop COPD and lose lung function quickly.

This quick, low-cost test can help doctors identify at-risk people early. In the future, these individuals can receive closer monitoring, quit smoking earlier, and take simple steps to protect their lungs and slow disease progression.

Chronic obstructive pulmonary disease (COPD) is a leading cause of illness and death and can cause difficulty breathing or shortness of breath and flare-ups or exacerbations. Pulmonary rehabilitation is a recommended therapy that improves an individual’s ability to perform everyday tasks and their quality of life, or overall well-being. Unfortunately, access to pulmonary rehab remains limited, in part due to the lack of enough programs in some areas and other difficulties such as transportation problems and too many other medical appointments

We conducted a study of 278 patients with COPD who were referred to a virtual pulmonary rehab program at a single medical center between 2023 and 2025. The virtual program was delivered via live, real-time video/computer visits to patients’ homes and included supervised exercise training, education, and support. We studied how many individuals took part in the program, difficulties or barriers that kept individuals from enrolling in the program, and changes in the health of participants who completed the program. Overall, 23% of referred patients enrolled in the virtual pulmonary rehab program. The most reported reason for not enrolling was lack of insurance coverage. For individuals who completed the program, their participation was associated with improvements in their abilities to exercise, their breathlessness and depression symptoms, and how their health was affecting their day-to-day life.

Although virtual pulmonary rehab programs may ease some of the traditional barriers to participating and insurance coverage problems remain a significant barrier to giving everyone a fair chance to participate, regardless of their background or resources.

Chronic obstructive pulmonary disease (COPD) is a serious lung condition that affects millions and can lead to flare-ups or exacerbations that are life threatening. While air pollution is a well-known trigger for worsening COPD and causing exacerbations, much less is known about how pollen (a fine powder produced by plants to fertilize or reproduce with other plants)affects the lungs of people living with COPD.

In this study, we followed 30 people with moderate-to-severe COPD in Boston over one year. Participants measured their own lung function at home every morning using a handheld breathing device, providing nearly 1,800 measurements during pollen season. We compared these daily lung function readings with regional pollen levels recorded nearby.

We found that higher pollen levels in the 3 days before a breathing test were associated with reduced lung function — specifically, a lower score on a key breathing measure called forced expiratory volume in 1 second (FEV₁), which reflects how much air someone can forcefully exhale. This result was most noticeable in participants who had both COPD and a history of asthma, and in those with higher levels of inflammation in their blood.

These findings suggest that pollen exposure can worsen airflow in people with COPD, particularly those with overlapping asthma or higher measurements of chronic or ongoing inflammation. As climate change continues to widen and intensify pollen seasons, people with COPD may benefit from monitoring pollen forecasts and taking steps to limit exposure on high-pollen days.

This study was the first to explore knowledge, attitudes, and preferences about gene therapy among people with alpha-1 antitrypsin deficiency (AATD), an inherited condition that carries an increased risk of lung and liver disease. Gene therapy is a means of treating or preventing a disease by correcting the underlying genetic problem—it works by replacing, repairing, or turning off faulty genes inside the body's cells. Understanding the patient perspective or view is important to ensure that therapies are acceptable to the people who may use them.

Participants were recruited through AlphaNet, a disease management organization. Over a thousand people completed our survey and knowledge test. Participants’ knowledge about AATD-specific genetics was high, moderate regarding clinical trials, and low regarding genes, gene expression, and genetic therapies. Opinions of gene therapy were overall favorable, and participants with higher knowledge scores reported more support of gene therapy and a higher interest in participating in a gene therapy clinical trial. Participants preferred gene therapies capable of targeting both liver and lung disease and therapies with less frequent re-dosing. Participants expressed desire for additional education and high levels of trust in the Alpha-1 Foundation, AlphaNet, and their AATD-specific healthcare providers.

These results illustrate the importance of gene therapy education, which would ultimately benefit clinical trial enrollment and ensure that education, therapies, trials, and care match patient preferences, needs, and expectations.

Listening to the lungs with a stethoscope remains a basic part of patient care, but the result depends heavily on the doctor's training and experience. Digital stethoscopes can now record lung sounds and computers can analyze them. However, most existing methods only label sounds as normal or abnormal, without explaining what is happening inside the lungs.

In this study, we recorded lung sounds from 235 adults using a digital stethoscope: 62 healthy individuals, 85 patients with stable chronic obstructive pulmonary disease (COPD), and 88 patients during a COPD flare-up or exacerbation. For each recording, we measured 4 features: the main pitch of the breathing sounds, how steady the sound energy was, the vibration of the sound, and how regular the overall sound was.

Each measurement reflected a different feature of COPD. Stable COPD patients had lower-pitched sounds and stronger vibration patterns, while patients during an exacerbation showed the most chaotic sound structure. Together, the 4 measurements form an acoustic map—a representation of the different lung sounds associated withCOPD. The map does not replace diagnosis but gives doctors a clearer view of the underlying lung changes.

Bronchiectasis is a chronic lung disease that is more common in women after menopause, but it is not fully understood how female reproductive history (a summary of a woman’s periods, pregnancies, and menopause) may affect the risk of developing the condition. This study examined nearly 97,000 postmenopausal women participating in the Women’s Health Initiative to determine whether reproductive lifespan — the number of years between the start of menstruation and menopause — was linked to a risk of developing bronchiectasis.

We found that women with a longer reproductive lifespan had a lower risk of developing bronchiectasis. Women whose reproductive lifespan was 40 years or longer had a 12% lower risk compared with women whose reproductive lifespan was less than 30 years. This relationship was strongest in women who had never used hormone therapy. In that group, women with the longest reproductive lifespan had a 22% lower risk of bronchiectasis. In contrast, hormone therapy use itself was associated with a 19% higher risk of bronchiectasis.

These findings suggest that lifetime exposure to natural female hormones (i.e., hormones produced in a woman’s body, not hormones taken as part of hormone therapy) may influence bronchiectasis risk in postmenopausal women.

Did you know that a simple breath test can tell us more about lung health? We studied 5,842 adults from a nationwide U.S. health survey to understand whether a measurement called the fractional exhaled nitric oxide, or FeNO, is linked to better lung function and longer life—even in people who do not have blocked airways.

We followed participants for up to 10 years. During that time, 255 people died. We found that people with higher FeNO levels were less likely to report chronic cough or wheezing. For every increase in FeNO, their lung capacity improved by about 28 milliliters. For people with very low FeNO levels, the risk of death was higher. As FeNO increased, the risk dropped and then leveled off.

Why does this matter? FeNO is already used to manage asthma. Our study suggests it might also help doctors identify individuals at higher risk of developing COPD, even before they develop typical breathing problems. This could lead to earlier check-ups and better prevention strategies.