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It is known that exposure to tobacco smoke is a substantial risk factor for many acute respiratory bacterial infections, including pneumonia 26 and meningococcal disease 27 , as Streptococcus pneumoniae , a pneumonia pathogen, downregulates the tight junction proteins Claudin-7 and -10 28 , while Neisseria meningitidis , which causes meningococcal pneumonia, disrupts occludin, another tight junction protein 29