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24 Briefly, patients clinical notes were reviewed three times over 2 years: at baseline (when COPD patients in the EC group first reported EC use), at 121.5 months (follow-up visit 1

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In addition, exposure to tobacco smoke extract (TSE) exposure can cause human macrophages to release EVs (including exosomes and ectosomes), which contribute to the release of matrix metalloproteinase 14 (MMP14) and may contribute to emphysema [102, 103]