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Abbreviations BAL: Bronchoalveolar lavage BALF: Bronchoalveolar lavage fluid COPD: chronic obstructive pulmonary disease CS: cigarette smoke CSE: cigarette smoke extract ELF: epithelial lining fluid GSH: glutathione References Pryor WA, Stone K: Oxidants in cigarette smoke

Studies with complete reporting and rigorous design were rated as "High," while others with some limitations or missing methodological details were rated as "Medium" or "Low." To evaluate the reliability and scientific rigor of the evidence presented in this review, we conducted a methodological quality assessment of the primary clinical trials included