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The main features of initial epithelial injury are mucociliary dysfunction, goblet cell hyperplasia, and disruption of tight junction proteins, changes that together impair mucociliary clearance and compromise barrier integrity ( Expansion Phase Immune cell recruitment mediator release critical pathway activation transition to senescence Small airway inflammation is induced by chronic exposure to cigarette smoke and atmospheric particulate matter

doi:10.1136/tobaccocontrol-2021-057095