Various studies support the fact that exosomes containing miRNA, lncRNA, and proteins that are involved in the pathogenesis of COPD (12, 13), many exosomes, including miR-101, miR-223, miR-144, and miR-1274a act by influencing the molecular pathways associated with the pathogenesis of COPD which includes Kras, Notch, Smad, and TGF-β (14). This evidence concerns the gene TGFB1 and chronic obstructive pulmonary disease.