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Another study on emphysema mice demonstrated that cigarette smoke not only increased the percentage of IL-21 + Th17 and IL-21R + CD8 + T cells in peripheral blood, but also enhanced their expressions of IL-17 and IL-21, which in turn upregulated perforin and granzyme B in CD8 + T cells, indicating that cytotoxic function of CD8 + T cells can be regulated by Th17 cells in emphysema [58]