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Cigarette smoke (CS) poses a significant risk factor for respiratory, vascular, and organ diseases owing to its high content of harmful chemicals and reactive o

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Cigarette smoke (CS) poses a significant risk factor for respiratory, vascular, and organ diseases owing to its high content of harmful chemicals and reactive oxygen species (ROS). These substances are known to induce oxidative stress, inflammation, apoptosis, and senescence due to their exposure to environmental pollutants and the presence of oxidative enzymes. The lung is particularly susceptible to oxidative stress (Cha et al., 2023). Smoking causes damage alveoli where the oxygen exchange occurs. In emphysema the alveoli coalesce to form a large cavity and the surface area available for gas exchange decreases. Chronic obstructive pulmonary disease (COPD) represents the fourth leading cause of morbidity and mortality in North America, in excess of 110,000 yearly deaths (Yoshida & Tuder, 2007).            β-agonists up-regulate the transport of both sodium and chloride ions through the increase in intracellular cAMP caused by β-adrenoceptor stimulation (Bassford et al., 2012). β2-Agonists are effective bronchodilators due primarily to their ability to relax airway smooth muscle (ASM). They exert their effects via their binding to the active site of β2-adrenoceptors on ASM, which triggers a signaling cascade that results in a number of events, all of which contribute to relaxation of ASM (Rossi et al., 2008). Although β-agonists are bronchodilators some adverse events can occur such as increased heart rate and palpitations, because some of the β-ARs in the atria and ventricles are β2, and thus even selective β2-agonists can provoke direct simulation of the heart. Moreover, stimulation of β2-ARs can result in vasodilation and reflex tachycardia (Cazzola et al., 2013).            Chronic obstructive pulmonary diseases (COPD), comprised of pulmonary emphysema, chronic bronchitis, and structural and inflammatory changes of small airways, is a leading cause of morbidity and mortality in the world. Smoking cigarettes induces cell death. Cigarette smoke has been associated with various molecular and cellular changes in the lung tissue, it has also been associated with lung and blader cancer as well as cardiac issues and complications. Smoke cessation is imperative to avoid any heart and long complications. References Cha, S.-R., Jang, J., Park, S.-M., Ryu, S. M., Cho, S.-J., & Yang, S.-R. (2023, June 3). Cigarette smoke-induced respiratory response: Insights into cellular processes and biomarkers. Antioxidants (Basel, Switzerland). https://pmc.ncbi.nlm.nih.gov/articles/PMC10295620/ Mannino, D. M. (2015, November). Smoking and emphysema - chest. Smoking and Emphysema. https://journal.chestnet.org/article/S0012-3692(15)50217-1/fulltext Yoshida, T., & Tuder, R. M. (2007, July 1). Pathobiology of cigarette smoke-induced chronic obstructive pulmonary disease | physiological reviews. https://journals.physiology.org/doi/full/10.1152/physrev.00048.2006 Bassford, C. R., Thickett, D. R., & Perkins, G. D. (2012, March 20). The rise and fall of β-agonists in the treatment of ARDS - Critical Care. BioMed Central. https://ccforum.biomedcentral.com/articles/10.1186/cc11221#:~:text=%CE%B2-agonists%20up-regulate%20the%20transport%20of%20both%20sodium%20and,increase%20in%20intrac Rossi, A. M., Khirani, S. M., & Cazzola, M. M. (2008, December 3). Long-acting beta2-agonists (LABA) in chronic obstructive pulmonary disease: Efficacy and safety. International journal of chronic obstructive pulmonary disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC2650610/ Cazzola, M., Page, C. P., Rogliani, P., & Matera, M. G. (2013, January 10). Β 2 -agonist therapy in lung disease - ATS journals. β2-Agonist Therapy in Lung Disease. https://www.atsjournals.org/doi/full/10.1164/rccm.201209-1739PP

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