In a study involving 45 patients with COPD acute exacerbation and 45 healthy smokers who served as a control group, levels of coenzyme Q10 and the copper/zinc ratio was significantly lower in the patient group than the control group. In addition, the patient group was found to have lower forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) and higher C-reactive protein, white blood cell count, and sedimentation rate. The authors conclude, "The decrease in CoQ10 level and Cu/Zn ratio and elevation in Cu and Zn levels observed in the patients probably result from the defense response of organism and are mediated by inflammatory-like substances."