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The whole system works together as the first-line defence to protect and limit the damage caused by stress ( Chronic exposure to cigarette smoke, which is the main risk factor for COPD, as well as repeated infections, cause changes in the epithelium including loss of ciliated epithelial cells ( Severe asthma is a chronic inflammatory disease classified as heterogenous in relation to clinical phenotype, severity, and the response of the epithelium to injury

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