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SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) is a multicentre National Institutes of Health funded cohort study of nearly 3000 never-smokers and ever-smokers (≥ 20 pack-years) with and without chronic obstructive pulmonary disease (COPD). It was designed to help fill gaps in our understanding of the biological complexity and clinical heterogeneity of COPD. The original goals for this study were to identify subgroups of smokers who may benefit from targeted therapies and to discover and validate intermediate biomarker endpoints. Here we review important findings from SPIROMICS over the past five years, including the impact of environmental and occupational exposures on the respiratory health of smokers, the characterisation of symptomatic smokers with preserved pulmonary function and the investigation of several diagnostic and prognostic biomarkers such as airway mucin concentration, functional small airways disease on chest computed tomography and a gene expression signature of interleukin 17A response in airway epithelium. (BRN Rev. 2019;5(4):233-48) Corresponding author: MeiLan K. Han, mrking@umich.edu

Insights into Chronic Obstructive Pulmonary Disease Epidemiology, Phenotypes and Outcomes from SPIROMICS