sRAGE is a decoy receptor of RAGE that detects stresses like hypoxia and oxidative stress and binds ligands associated with damage-associated molecular patterns to protect against inflammation.[31,63] Increasing evidence suggests that lower sRAGE levels may play a mechanistic role in worse lung function outcomes including COPD status as well as reduced DLco[31] and greater emphysema severity;[64] thus, lower sRAGE levels may reflect damage to airways or lung parenchyma respectively. This evidence concerns the gene AGER and pulmonary emphysema.