This is a 3 year longitudinal study to identify novel endpoints and compare these with standard measures such as forced expiratory volume in 1 second (FEV1) for their ability to measure and predict COPD (Chronic Obstructive Pulmonary Disease) severity and its progression over time. Control subjects (smokers and never smokers) will be recruited as comparators with the COPD subjects.

Inclusion criteria:

• COPD Subjects
• A COPD subject will be eligible for inclusion in this study only if all of the following criteria apply:
• Male or female subjects, aged 40-75 years inclusive
• A baseline (post-bronchodilator) FEV1 <80% of predicted normal and a baseline (post-bronchodilator) FEV1/FVC ratio 70%
• Current or ex-smokers with a smoking history of at least 10 pack-years (number of pack years = (number of cigarettes per day / 20) x number of years smoked e.g., 20 cigarettes per day for 10 years, or 10 cigarettes per day for 20 years).
• A signed and dated written informed consent is obtained prior to participation
• Able to comply with the requirements of the protocol and be available for study visits over 3 years

Control Subjects - Current/Ex Smokers

• A control subject will be eligible for inclusion in this study only if all of the following criteria apply:
• Male or female subjects, aged 40-75 years inclusive, who are free from significant disease as determined by history, physical examination and screening investigations
• Baseline (post-bronchodilator) FEV1 >85% of predicted normal. FEV1/FVC ratio >70%
• Current or ex-smokers with a smoking history of at least 10 pack-years (number of pack years = (number of cigarettes per day / 20) x number of years smoked e.g., 20 cigarettes per day for 10 years, or 10 cigarettes per day for 20 years).
• A signed and dated written informed consent is obtained prior to participation.
• Able to comply with the requirements of the protocol and be available for study visits over 3 years

Control Subjects - Non-smokers

• A non-smoking control subject will be eligible for inclusion in this study only if all of the following criteria apply:
• Male or female subjects, aged 40-75 years inclusive, who are free from significant disease as determined by history, physical examination and screening investigations
• Baseline (post-bronchodilator) FEV1 >85% of predicted normal. FEV1/FVC ratio >70%
• Non-smokers with a smoking history of < 1 pack-year (number of pack years = (number of cigarettes per day / 20) x number of years smoked).
• A signed and dated written informed consent is obtained prior to participation.
• Able to comply with the requirements of the protocol and be available for study visits over 3 years

Exclusion Criteria:

COPD Subjects

• A COPD subject will not be eligible for inclusion in this study if any of the following criteria apply:
• Known respiratory disorders, or disorders identified at screening/visit 1 (including identification on the first CT scan), other than COPD (e.g.: lung cancer, sarcoidosis, tuberculosis, lung fibrosis, cystic fibrosis)
• Known history of significant inflammatory disease, other than COPD (e.g. rheumatoid arthritis and Lupus)
• Known to be severely alpha-1-antitrypsin deficient (PI SZ or ZZ)
• Having undergone lung surgery (e.g. lung reduction, lung transplant)
• Have cancer or have had cancer in the 5 years prior to study entry
• Serious, uncontrolled disease (including serious psychological disorders) likely to interfere with the study or impact on subject safety
• Is enrolled in a long term blinded drug study (subjects in open label studies may be considered and subjects in short blinded studies (approx less than 12 weeks may be considered following consultation with sponsor) or a study where there is significant radiation exposure (e.g.: CT scans)
• Have, in the opinion of the investigator, evidence of alcohol, drug or solvent abuse
• Have received a blood transfusion in the 4 weeks prior to study start
• Has experienced a moderate or severe exacerbation (requiring oral corticosteroid, antibiotics or hospitalisation) within the last 4 weeks. All courses of oral corticosteroids and antibiotics must be completed at least 2 weeks before study start
• Is on long term oral corticosteroids (long term is considered use for more than 3 consecutive months)
• Unable to walk
• Subject is a participating investigator, sub-investigator, study co-ordinator, or employee of a participating investigator, or is an immediate family member of the aforementioned.

Control Subjects

• A control subject will not be eligible for inclusion in this study if any of the following criteria apply:
• Known respiratory disorders, or disorders identified at screening/visit 1 including identification on the first CT scan (e.g.: COPD, asthma, lung cancer, sarcoidosis, tuberculosis, lung fibrosis)
• Known history of significant inflammatory disease (eg rheumatoid arthritis and Lupus)
• Known to be severely alpha-1-antitrypsin deficient (PI SZ or ZZ)
• Having undergone lung surgery (e.g. lung reduction, lung transplant)
• Have cancer or have had cancer in the 5 years prior to study entry
• Serious, uncontrolled disease (including serious psychological disorders) likely to interfere with the study
• Is enrolled in a long term blinded drug study (subjects in open label studies may be considered and subjects in short blinded studies (approx less than 12 weeks may be considered following consultation with sponsor) or a study where there is significant radiation exposure (e.g.: CT scans)
• Have, in the opinion of the investigator, evidence of alcohol, drug or solvent abuse.
• Have received a blood transfusion in the 4 weeks prior to study start
• Is on long term oral corticosteroids (long term is considered use for more than 3 consecutive months)
• Subject is a participating investigator, sub-investigator, study co-ordinator, or employee of a participating investigator, or is an immediate family member of the aforementioned.

COPD subjects and smoking and non-smoking controls