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This not only creates a significant economic burden but also has social implications [38, 39]

This dysregulation is driven by environmental factors such as cigarette smoke (CS) and amplified by dysregulated expression of molecules including prostaglandin E synthase (PTGES), Hedgehog-interacting protein (HHIP), and hypoxia-inducible factor-1 (HIF-1)forming a vicious cycle of environmental damagemetabolic reprogrammingpathological progression. Aberrant glycolysis in COPD patients serves as a critical metabolic basis for airway remodeling and persistent inflammation