Meanwhile, in the present study, the intervention of EVs derived from patients with HUA could increase the expression of cell senescence specific markers (CDKN1A/p21, CDKN2A/p16 and IL-1A) [50, 51] and DNA damage response marker 53BP1 proteins [52] in COPD cell model. Here, IL1A is linked to chronic obstructive pulmonary disease.