These biomarkers (AGER, ICAM1 and CCL20) were associated with emphysema regardless of quantification technique (%LAA ≤ −950 and ≤ −910 HU and LP15A) and were replicated in an independent COPD cohort (TESRA), thus strengthening their potential utility for defining clinically relevant emphysema. The gene discussed is ICAM1; the disease is pulmonary emphysema.