Chronic Obstructive Pulmonary Disease (COPD) has historically been considered a self-inflicted disease induced by tobacco smoking.¹ There is no question that tobacco smoking is one of the main risk factors for COPD (as well as other diseases), and that preventing smoking initiation in adolescence and favouring quitting as early as possible is a must. Yet, we propose that what we call COPD today is in fact the common end-result of a set of different dynamic environment–gene interactions (including, but not limited to, smoking) that can occur during the entire lifespan of an individual, both before and after birth, that compromise one or two key physiological processes—lung development and lung ageing (figure).

中文翻译：

---

超越吸烟的COPD：新范式，新机遇

长期以来，慢性阻塞性肺疾病（COPD）被认为是由吸烟引起的自残疾病。¹毫无疑问，吸烟是COPD（以及其他疾病）的主要危险因素之一，因此必须防止在青春期开始吸烟，并提倡早日戒烟。但是，我们认为今天我们所说的COPD实际上是在个体的整个生命周期中可能发生的一系列不同动态环境的共同最终结果-基因相互作用（包括但不限于吸烟）在出生前和出生后，会损害一两个关键的生理过程-肺发育和肺衰老（图）。