“…Immune responses via innate immune macrophages [ 25 ], antigen-specific responses [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], CD4 + Foxp3 + Treg [ 7 , 19 , 38 , 39 , 40 ], and co-signaling and immune checkpoint receptors [ 41 ] play significant roles in modulating inflammation, autoimmunity, and tumor growth. Cigarette smoke (SM) affects both innate and adaptive immunity, playing dual functions in regulating immune responses and leading to dysfunctional innate and adaptive host immunity such as T cell impairment, Treg reduction, dysregulation of the inflammatory response, and causing several inflammatory diseases including respiratory diseases, COPD, and atherosclerotic cardiovascular diseases [ 42 , 43 , 44 , 45 , 46 ].…”