A review article in 2013 suggested that dual PCSK9 and statin therapy might amplify potential safety issues, including those related to respiratory infections, given that both act to increase levels of LDLR and VLDLR.58 What is unclear is whether PCSK9 inhibitors in clinical use (or under development) alter pulmonary VLDL receptor levels and, thus, whether genetic findings reflecting life-long systemic changes in PCSK9 have clinical relevance to patients receiving long-term treatment with tissue-localized PCSK9 inhibitors. This evidence concerns the gene VLDLR and respiratory tract infectious disorder.