It is possible that bronchial epithelial-derived ADAM15 contributes to airflow obstruction by promoting the progression of the small airway disease phenotype in patients with COPD via effects on epithelial cells (such as promoting epithelial cell to mesenchymal cell transition) or increasing bronchial epithelial cell secretion or activation of mediators that promote activation of (myo) fibroblasts in the airways. Here, ADAM15 is linked to chronic obstructive pulmonary disease.