HHIP and chronic obstructive pulmonary disease: Notably, although the Warburg effect was observed in COPD-derived ASMCs as indicated by increased lactate levels and decreased OCR compared to normal ASMCs, transient overexpression of HHIP attenuates increased lactate levels modestly without influencing OCR in COPD-derived ASMCs, indicating incomplete rescue of metabolic reprogramming in COPD-derived ASMCs by resuming HHIP levels, possibly due to insufficient genetic changes over a short period against decades of accumulated metabolic.