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Inorganic nanoparticles are simpler to produce and modify but raise concerns about biocompatibility

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However, factors such as cigarette smoking, subclinical infections, environmental pollutants, occupational exposures, chronic microaspiration of gastric content, abnormal lung microbiota composition, and genetic predisposition may cause repeated AEC injury ( Complex bidirectional interactions between epithelial cells, mesenchymal cells, and ECM subsequently induce a series of cellular events, including fibroblasts differentiation into myofibroblasts, migration, proliferation, and activation of AECs and fibroblasts, inhibition of apoptosis, and persistent abnormal ECM secretion

PMID 17524376