In addition to the smoking model of emphysema, hyperlipidemia alone, as is seen in the ApoE knockout mouse fed a high fat diet, is sufficient to cause peribronchial and perivascular inflammation through TLR4 activation leading to emphysema development (Goldklang et al., 2012), suggesting a new mechanism linking emphysema and cardiovascular disease. Here, APOE is linked to pulmonary emphysema.