Elevated extracellular GrB levels were found in biological fluids, as in plasma from patients with acute myocardial infarction (36), atherosclerosis (37), obesity and T2D (51, 52), in broncho-alveolar lavage (BAL) in chronic obstructive pulmonary disease (COPD), pneumonia, and asthma (8), and in the synovial fluid in rheumatoid arthritis (53). The gene discussed is GZMB; the disease is chronic obstructive pulmonary disease.