Kawamoto T, et al. - Researchers assessed the contributions of small airways obstruction and alveolar destruction to airflow limitation in chronic obstructive pulmonary disease (COPD) by using two biomarkers, pentosidine and vascular endothelial growth factor (VEGF). Study participants included non-smokers, smokers without COPD, and smokers with COPD. Significantly higher pentosidine levels were detected in smokers with COPD vs in non-smokers and smokers without COPD. Significantly lower VEGF levels were detected in smokers without COPD vs in non-smokers, and further decreased in smokers with COPD. Pentosidine level accounted for the severity of small airways obstruction. VEGF level was indicative of the magnitude of alveolar destruction. In order to differentiate the severity of small airways obstruction from alveolar destruction, simultaneous measurement of pentosidine and VEGF levels may be a promising approach.