Age

18–70

Sex

ALL

Healthy volunteers

Not accepted

Case definition: Smokers (\>20 pack-year) with airflow obstruction (FEV1/FVC\<70) and FEV1\>50% predicted (early COPD GOLD 1 or 2)
Control definition: Smokers with normal spirometry will serve as controls.

FEV1 \< 50% NOT 70
Significant cardiovascular disease defined as abnormal EKG, known or suspected coronary artery disease or congestive heart failure.
Diabetes mellitus
Significant liver or renal disease
Severe coagulopathy (INR \> 1.4, PTT \> 40 seconds and platelet count \< 150x103 cells).
Pregnancy
ETOH use of more than \>6 beers or \>4 mixed drinks daily
Lack of capacity to provide informed consent.
Antibiotic use within the prior 2months

Lung Microbiome and Inflammation in Early COPD