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Deregulation of the chemokines, cytokines, and growth factors that determine collagen deposition and the MMPs and serine proteases that control its degradation could account for both the thickening of the airway walls and the emphysematous destruction of the peripheral lung in COPD

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It reduces blood flow to the hands and feet, causing skin ulcers, chronic pain, tissue damage, and even gangrene in severe cases

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& Ormerod, S

[DOI] [PMC free article] [PubMed] [Google Scholar] 24.Goldberg ME, Liefeld J, Madill J, et al