SP-D knockout mice also have an enhanced susceptibility to cigarette smoke-induced airway inflammation with influx of alveolar macrophages, secretion of chemokine (C-C motif) ligand 3 (CCL3) and IL-6 and upregulation of ceramide genes; rfhSP-D alleviates this in vivo phenotype and attenuates cigarette smoke induced human epithelial cell apoptosis (108). The gene discussed is CCL3; the disease is inflammatory response.