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TNF, which can be elevated in COPD, significantly increased the expression of intercellular adhesion molecules VCAM1, ICAM1, and E-selectin as well as the cytokines CCL2 (C-C motif ligand 2) and CX3CL1 (C-X3-C motif chemokine ligand 1) [136]

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However, funding did get virtually zeroed out or decreased by $1 million or more in eleven other states Alaska, California, Iowa, Maryland, New Hampshire, North Carolina, Ohio, Oregon, South Dakota, Washington and Wyoming almost canceling out the gains

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