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Cadmium is a heavy metal of considerable toxicity found in CS, which has been shown to influence the phagocytic and microbiocidal capacity of murine AMs.74 Cadmium levels were significantly elevated (ninefold) in BAL from human smokers, which correlated with loss of membrane Rac2 and p67 phox localisation and NOX2-derived ROS synthesis.75 In the same study, in CS exposed mice, cadmium inhibited Rac2 activation needed for the generation of ROS in lung macrophages, recovery of Rac2 function reduced Streptococcus pneumoniae bacterial burden and increased survival

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