In this issue of CHEST (see page 926), Mahler and coauthors show that IV infusion of ABX-IL-8, administered monthly for a 3-month period, improved symptoms of dyspnea, as indicated by the significant and clinically relevant increase in the transition dyspnea index total scores during the treatment in the group with moderate-to-severe COPD (average FEV1, 42% predicted) compared to those of the group treated with placebo. Relief of dyspnea was evident at 2 weeks after the first infusion and persisted for a 2-month period. The authors did not observe significant differences in lung function, health status, 6-min walking distance, and number of adverse events between the two groups examined. The pilot study of Mahler et al shows that treatment with ABX-IL-8 is safe and well-tolerated, and that the number of adverse events were similar between the treatment and placebo groups. This study represents the first report of a trial of monoclonal antibody therapy targeted against an important chemokine in patients with COPD, providing preliminary support for further investigation and opening up new perspectives for therapeutic intervention. These data, however, need to be confirmed in a larger case series, as markers and the mechanism of action of biological agents in COPD patients were not elucidated. The investigation of these factors certainly would contribute to a better selection of patients appropriate for targeting: investigating the optimal dose to achieve sufficient concentration in the airway; evaluating the benefit/safety profile of the treatment over a longer time period (at least 1 year); and selecting the most adequate outcome measures. Furthermore, the following question remains open: since measurements of IL-8, IL-8 receptors, and neutrophils in biological samples (ie, from sputum, BAL, and bronchial biopsies) were not performed in this study, how does ABX-IL-8 treatment influence these inflammatory markers?