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A transmigration of activated leukocytes (such as monocytes) is furthermore supported by an increased endothelial expression of intercellular adhesion molecule 1 (ICAM1), endothelial leukocyte adhesion molecule 1 (E-selectin), and vascular cell adhesion molecule 1 (VCAM1) due to cigarette smoke components interacting with the endothelium and a cigarette smoke-dependent activation of the pro-inflammatory transcription factor nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-B) [12, 88]

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Diagnosis can be made relatively easily on clinical symptoms alone, especially in patients who also have skin involvement

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Pulmonary eosinophilic inflammation can suddenly occur after CS exposure, and then patients with AEP can progress from mild dyspnea to life-threatening respiratory failure (Watanabe et al., 2002