Immunostaining for lipid peroxidation product 4-hydroxy-2-nonenal (4-HNE) adduct in the lungs of smokers with and without chronic obstructive pulmonary disease (COPD). Immunostaining for lipid peroxidation product 4-hydroxy-2-nonenal (4-HNE) adduct in the lungs of smokers with and without chronic obstructive pulmonary disease (COPD). Immunohistochemistry showing increased staining in both bronchial and alveolar epithelium in smokers without (a, b) and with (c, d) COPD. e) 4-HNE staining score showing increased staining in COPD. *: p<0.05; **: p<0.01. f) Correlation between 4-HNE staining score in the lungs and per cent predicted forced expiratory volume in one second (FEV1). R = −0.76; p<0.05. Reproduced with permission 48. W. MacNee Eur Respir Rev 2005;14:12-22 ©2005 by European Respiratory Society