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Pharmacological studies have confirmed that anti-inflammatory and immunomodulatory effects were mainly found in 14- and 15-membered ring macrolides, such as EI and AZI [63], which may explain why SPI showed no obvious effects on CS-induced airway epithelial barrier dysfunction

Although further studies are needed to corroborate our results, our study is important because there is an urgent need for new smoking cessation strategies for COPD patients, as smoking cessation is the only treatment capable of halting disease progression and increasing survival

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