ET-1 levels, both in EBC and in the arterial samples, positively correlated to pulmonary-artery systolic pressure, while arterial concentration of ET-1 negatively correlated with FEV1%, indicating that enhanced ET-1 levels in biological sample might early occur in PAH secondary to COPD, and actively participate in stimulating vascular and airway remodelling, through an endogenous increased production by the endothelium, and by a partial release and uptake into the airway epithelium. The gene discussed is EDN1; the disease is chronic obstructive pulmonary disease.