These observations were later corroborated in a larger cohort demonstrating that pIgR epithelial expression is mainly decreased in the airway epithelium from severe COPD patients, as compared with non-smoker controls, non-COPD smokers and less severe COPD patients, and associated with a persistence of the defect in primary cultures of bronchial epithelial cells from such patients where the mechanism could be shown as involving TGF-β signalling [68]. This evidence concerns the gene PIGR and chronic obstructive pulmonary disease.