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Updated: Nov 2, 2025
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Published on: June 20, 2020
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Determinants of Lung Fissure Completeness
Marieke C van der Molen1,2, Jorine E Hartman1,2, Cornelis J Vermeulen2
1Department of Pulmonary Diseases.
Summary
Fissure completeness, important for COPD phenotyping, is primarily determined by genetics, not by COPD severity or environmental factors. This finding impacts understanding of lung development and disease.
Area of Science:
- Pulmonary Medicine
- Genetics
- Radiology
Background:
- Advanced bronchoscopic treatments for severe chronic obstructive pulmonary disease (COPD) necessitate refined COPD phenotyping.
- Fissure completeness, a measure of lung fissure integrity, is an emerging factor in COPD research.
- Understanding factors influencing fissure completeness is crucial for personalized COPD management.
Purpose of the Study:
- To investigate clinical, environmental, and genetic determinants of fissure completeness in individuals with and without COPD.
- To identify associations between fissure completeness and factors like race, smoking, and COPD status.
- To explore the genetic underpinnings of fissure completeness using genome-wide association studies.
Main Methods:
- Quantitative CT analysis of chest CT scans from 9,926 participants in the COPDGene study.
- Assessment of fissure completeness at baseline and 5-year follow-up.
- Genome-wide association analyses stratified by race (non-Hispanic White and African American subjects).
Main Results:
- African American subjects exhibited significantly higher fissure completeness compared to non-Hispanic White subjects across all three fissures.
- No significant changes in fissure completeness were observed between baseline and 5-year follow-up.
- No clinically relevant differences in fissure completeness were associated with COPD severity, smoking, or other clinical/environmental factors.
- Genome-wide significant associations with fissure completeness were identified in both non-Hispanic White and African American cohorts, implicating specific genetic loci.
- Certain identified genetic variants correlate with WNT5A and HOXB antisense RNA expression, suggesting a role in embryogenesis.
Conclusions:
- Fissure completeness is predominantly genetically determined.
- Fissure completeness is independent of age, sex, smoking status, and COPD presence or severity.
- Maternal factors such as smoking during pregnancy or maternal COPD do not influence fissure completeness.
- Genetic factors play a key role in lung fissure development, with implications for understanding respiratory conditions.
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