TFAM and chronic obstructive pulmonary disease: TFAM protein is significantly lower in the quadriceps muscle of patients with moderate-to-very severe COPD than in controls and TFAM mRNA and protein are also significantly lower in patients with cachectic COPD compared to that in both non-cachectic patients and control subjects [19] The level of TFAM protein is related to apoptosis of pulmonary vascular endothelial cells.