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Akt: Ak strain transforming AMPK: adenosine monophosphate-activated protein kinase EMT: epithelial to mesenchymal transition ERK: extracellular signal-regulated kinase GOT1: glutamic-oxaloacetic transaminase 1 GSH: glutathione H 2 O 2 : hydrogen peroxide HIF-1: hypoxia-inducible factor 1-alpha IL-2: interleukin-2 MAPK: mitogen-activated protein kinase MMP-9: matrix metallopeptidase 9 mTOR: mammalian target of rapamycin NADPH: nicotinamide adenine dinucleotide phosphate NF-B: nuclear factor kappa-light-chain-enhancer of activated B cells NOX4: nicotinamide adenine dinucleotide phosphate oxidase 4 Nrf2: nuclear respiratory factor 2 PD-1: programmed cell death protein 1 PD-L1: programmed death ligand 1 PI3K: phosphatidylinositol 3-kinase PTEN : phosphatase and tensin homolog deleted on chromosome 10 ROS: reactive oxygen species SOD2: superoxide dismutase 2 TGF-: transforming growth factor beta Tim-3: T cell immunoglobulin and mucin-domain-containing protein-3 TLRs: toll-like receptors VEGF: vascular endothelial growth factor Authors acknowledge Sumeet Singh (Guru Nanak Dev University, Amritsar) for assistance in drawing figures

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Patients were assessed at baseline, 4, 8, and 12 weeks of treatment using the COPD assessment test (CAT) and St

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