ELN and chronic obstructive pulmonary disease: Exposure to EDPs also generates a specific adaptive immune response, creating auto-reactive T and B lymphocytes as well as antibodies in smokers and patients with asthma, emphysema, chronic obstructive pulmonary disease, systemic sclerosis, thoracic aortic aneurysms (AAs), as well as other diseases related to elastin degradation [37–40].