Chronic obstructive pulmonary disease begins when harmful particles enter the airways again and again. The most common source is cigarette smoke, but dust, fumes and biomass fuel smoke can also cause the same injury. When these toxins reach the airway lining, the cells react with strong irritation. They release chemical signals that call immune cells to the site. These immune cells try to remove the particles, but the effort creates ongoing inflammation. This inflammation makes the airway walls

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