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60 Examples include TB infection,65 the human papillomavirus,66,67 and, in areas of rural Thailand, the fungus Microsporum canis.68 Further work is needed to clarify or refute the existence of causal pathways linking infection with lung cancer. The tyrosine kinase inhibitors erlotinib and gefitinib are novel agents http://www.selleckchem.com/products/Decitabine.html for the treatment of lung cancer that bear particular relevance to the Asian population. These drugs have been shown to be particularly effective in adenocarcinomas of the lung, in never smokers, in patients of Asian ethnicity, especially women, and in those with proven endothelial growth factor receptor mutations.57,69 This topic will be further discussed in the Asia�CPacific respiratory health series by Professor T Mok.70 COPD is comprised of a heterogeneous group of disorders that includes chronic bronchitis (cough with sputum production), intrinsic airway narrowing (as in asthma) or loss of elastic pulmonary recoil (emphysema).71 The GOLD criteria (Global initiative for Chronic Obstructive Lung Disease72) has arbitrarily standardized the diagnosis of COPD, Tryptophan synthase defining the disorder by a reduction in the ratio of FEV1 to FVC and progressing in stages of severity by the degree fall in FEV1 expressed as a percentage of the predicted normal value. COPD by GOLD criteria begins at an arbitrary cut-off of FEV1/FVC selleck chemicals llc for example, the normal value for an Asian male subject of a given height is known to be less than that of an equivalent European Australian male subject73,74 and the same is true of other ethnic groups including indigenous Australians.75 Furthermore, spirometric measures for COPD diagnosis should be recorded after bronchodilator administration to separate asthma (i.e. reversible airflow obstruction) from of COPD (i.e. irreversible obstruction).71 Later in the Asia�CPacific respiratory health series, Professor Ip will discuss in detail the problems of lack of appropriate reference lung function values for Asian populations and the lack of suitable facilities in certain Asian sectors limits obtaining accurate spirometric values in all patients.76 Mortality and morbidity statistics for COPD often underestimate its contribution to ill health and death because it is frequently not diagnosed in people with mild disease or recorded as an underlying condition death certificates even in people with diagnosed disease77,78 (for example in patients who die from pneumonia but whose pre-morbid spirometry is unknown or not recorded). In general, COPD morbidity and mortality increase with age and with pack-years of tobacco smoking and decrease according to years since smoking cessation.