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The accumulation of neutrophils also activates a large number of inflammatory factors, generating more ROS and exacerbating oxidative stress, especially during exacerbations ( 2 O 2 , malondialdehyde, 4HNE (4-hydroxy-2-nonenal), and 8-isoprostane in exhaled breath condensate ( There is growing evidence of mitochondrial dysfunction in COPD ( A number of drugs have been developed that can selectively target mitochondria, but no clinical studies have been reported in patients with COPD

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Solar radiation, especially UV, is known to induce the activation of the MAPK pathways 5,29 , which in turn can upregulate the MMP expression 30,31 and alter the TGF-/Smads pathway 29

However nicotine isnt what causes cancer in smokers