A role for GrB-mediated apoptosis -either perforin-dependent apoptosis or anoikis- has been reported in inflammatory pulmonary diseases, including age-related diseases, as COPD (23, 38), and acute severe lung inflammatory diseases, as respiratory syncytial virus (RSV) pulmonary infections (24, 25). Here, PRF1 is linked to chronic obstructive pulmonary disease.