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Activated caspase-8 subsequently triggers pro-apoptotic caspases-9, -7, and -3, while downregulating anti-apoptotic proteins Bcl-xL and Bcl-2, thereby promoting apoptosis

Wilking, M., Ndiaye, M., Mukhtar, H

15 Collectively, these events lead to a vicious cycle of persistent inflammation and chronic oxidative stress, which results in protease-anti-protease imbalance, defects in tissue repair mechanisms, accelerated apoptosis in lung cells and progression of COPD

That's because the more stress you experience, the more your body produces free radicals that circulate throughout your body, bumping and bashing against cells, increasing oxidative stress