From May 17 through May 20, the American Thoracic Society (ATS) hosted its 2026 annual conference in Orlando, Florida. The 2026 ATS International Conference offered attendees access to exhibit and poster halls, networking opportunities, and a selection of informative scientific sessions.

Today’s 2026 ATS International Conference recap highlights abstracts presented at the conference that focused on chronic obstructive pulmonary disease (COPD) topics. Some descriptions and conclusions have been edited for brevity and clarity. To view all the COPD abstracts, along with all the other abstracts presented at the 2026 ATS International Conference, view the latest supplement issue of the American Journal of Respiratory and Critical Care Medicine.

COPD Abstracts from the 2026 ATS International Conference

Severe Alpha-1 Antitrypsin Deficiency – Are Never-Smokers Disease Free?

  • Description: Alpha-1 antitrypsin deficiency (AATD) is an under-diagnosed hereditary condition resulting from mutations in the SERPINA1 gene. Severe AATD (e.g., ZZ and Z Null genotype) can result in premature lung disease and airflow obstruction, especially in smokers. As smoking is directly linked to risk of lung disease, [the researchers] evaluated never smoking individuals to assess their lung health at diagnosis and over time.
  • Conclusion: Two-thirds of ZZ never smokers have an abnormal CT at diagnosis highlighting structural disease is extremely common even without smoke exposure. People with AATD are diagnosed too late as evidenced by the radiological abnormalities at diagnosis and lung function decline even in never smoking individuals. Despite increased awareness of AATD and [the] national targeted detection program, [clinicians] are still diagnosing people in their mid-40s with established COPD, even in never smokers. Consideration should be given to more effective screening and therapeutic interventions before significant disease burden is established.

Sex Differences in Mortality Benefits of a Smoking Cessation Intervention in COPD: 32.5 Year Follow-Up From the Lung Health Study

  • Description: The Lung Health Study was a randomized clinical trial of a smoking cessation intervention compared to usual care in individuals with expiratory airflow obstruction on spirometry and minimal symptoms. Participants were enrolled between 1986 and 1988.
  • Conclusion: The beneficial effects of a smoking cessation intervention have persisted over more than three decades of follow-up in females, but not in males. Reasons for this sex difference are not clear, but future analyses could explore whether these differences are explained by differences in smoking cessation success rates or by biological differences in nicotine metabolism and susceptibility to adverse effects of smoking.

Proteomics-Based Accelerated Aging Endotype Associated with Multiorgan Dysfunction and Mortality in COPD

  • Description: Circulating proteomic signatures quantify biologic aging across organ systems and have been associated with aging-related phenotypes and outcomes. [The researchers] hypothesized that a biologic aging endotype, with distinct protein mediator expression, associates with multiorgan dysfunction and mortality in COPD.
  • Conclusion: [The researchers] derived a “Biologic Age” endotype of 87 plasma proteins and developed a chronologic-age independent “Accelerated Aging” score reflecting biologic aging. Among those with COPD, “Accelerated Aging” independently associates with multiorgan dysfunction, functional impairment, and mortality. Validation in independent cohorts may establish proteomic aging metrics as integrative biomarkers for risk stratification.

Significance of Mucus Plugs in Early COPD: An Analysis of the Source Cohort

  • Description: The SPIROMICS Study of Early COPD Progression (SOURCE) was designed to investigate early disease mechanisms by defining biological and imaging correlates of COPD in younger individuals with a smoking history. [The researchers] applied a deep learning algorithm to baseline CT scans in the SOURCE cohort to evaluate the relationship between mucus plugging, lung function, and exacerbations.
  • Conclusion: In the SOURCE early COPD cohort, approximately 7% of participants exhibited mucus plugging, predominantly in the lower lobes. Mucus plugs were associated with increased emphysema and fSAD and more frequent exacerbations, supporting their potential as an early imaging biomarker of small airway dysfunction and disease activity.

Life Expectancy in Chronic Obstructive Pulmonary Disease

  • Description: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and age-standardized COPD mortality has increased substantially over the past few decades. Robust estimates of life expectancy and years of life loss (YLL) from COPD, which are important to patient care and policy decisions, are lacking. [The researchers] aimed to determine whether COPD results in lower life expectancy, and whether the years of life lost are associated with disease severity.
  • Conclusion: COPD is associated with lower life expectancy, including in adults who never smoked. The years of life lost with clinically significant COPD, GOLD stages 2 and above, was comparable to those noted with hypertension and diabetes.

Non-Contrast CT Assessment of Perfusion is Associated with Disease Progression in Pre-COPD

  • Description: Pulmonary vascular injury plays a key role in the development and progression of COPD. Perfusion abnormalities may reflect early vascular remodeling and gas exchange defects, but reliance on contrast-enhanced imaging limits population-level assessment. Non-contrast-based perfusion imaging biomarkers could enable earlier risk stratification of smokers at greater risk for COPD progression.
  • Conclusion: Low non-contrast PBV independently predicted multiple markers of disease progression, including accelerated functional decline and worsening gas trapping. Automated perfusion estimation from non-contrast CT may provide sensitive, scalable biomarkers of early vascular injury, improving risk stratification among smokers at risk for COPD progression.

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