It removes pathogens from the mucus layer through mucociliary clearance, establishes barriers through tight and adherent junctions, and activates and recruits immune cells in the submucosa through cytokine and chemokine production [26, 27]
For example, from 2000 to 2010, China experienced accelerated urbanization, leading to increased exposure to risk factors such as tobacco and environmental pollutants 46,47
However other hypotheses have been proposed [4, 70], involving smoking increasing cholesteryl ester transfer protein, reducing lecithin cholesterol acyltransferase activity, affecting apo-1 synthesis, or increasing triglycerides
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