“…Goblet cell hyperplasia is another process associated with respiratory disease pathologies, and has recently been modelled in vitro during sub-cytotoxic repeated exposures to diluted combustible cigarette smoke (but was not induced by HTP aerosol exposure) ( Haswell et al, 2021 ); Muc5AC is often used as a marker for mucin gene expression ( Behrsing et al, 2016 ; Bedford et al, 2022 ). Additionally, changes in inflammatory markers are used as a proxy of inflammatory responses in vitro , and a number of mediators, including the cytokines, TNFα and interleukins (ILs), and matrix metalloproteinases (MMPs), are associated with exposure to inhaled toxicants, including combustible cigarette smoke ( Behrsing et al, 2016 ; Czekala et al, 2021 ; Bedford et al, 2022 ; Langel et al, 2022 ). It is for the above reasons that these cellular processes (cilia activity (beat frequency and active area), FoxJ1 expression, changes in goblet cells, inflammatory readouts) are often used as in vitro indicators of potential responses to inhaled test articles ( Behrsing et al, 2016 ; Iskandar et al, 2017 ; Czekala et al, 2021 ; Bedford et al, 2022 ).…”