Garudadri S, et al. - In smokers with preserved spirometry (post-bronchodilator FEV₁ (forced expiratory volume in 1 second)/FVC (forced vital capacity) ≥0.70) from SPIROMICS, researchers investigated if symptoms, exacerbations, and functional measures of disease severity would be related to markers of systemic inflammation, similar to what is reported in bone fide COPD (chronic obstructive pulmonary disease), rather than elevated type 2 inflammation which is often present in asthma. They measured inflammatory markers related to COPD (C-reactive protein [CRP], fibrinogen, soluble TNF receptors [sTNFRSF1A & 1B], and blood/sputum neutrophils) and type 2 inflammation (IgE [immunoglobulin E], and blood/sputum eosinophils). They assessed the link of these markers with respiratory symptom burden (dichotomized by a COPD Assessment Test score cutoff of 10, diagnosis of chronic bronchitis), exacerbations, six-minute walk distance (6MWD), and lung function based on FEV₁. Findings revealed negative correlations of CRP and sTNFRSF1A levels with 6MWD. In this patient populace, enriched markers of inflammation including CRP and sTNFRSF1A were observed, implying an overlap with the underlying pathophysiology of COPD.