Therefore, we focused on secretion levels of these cytokines and found AATD macrophages had significantly elevated secretion levels of IL-8 and GM-CSF in response to cigarette smoke-induced EVs at both 8 and 24 h (p < 0.005) while there were no significant changes in the cytokine profiles of normal macrophages (Fig. 5A). Here, CSF2 is linked to alpha 1-antitrypsin deficiency.