<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 38-year-old man comes to the physician because of a 2-year-history of cough and progressively worsening breathlessness. He has smoked 1 pack of cigarettes daily for the past 10 years. Physical examination shows contraction of the anterior scalene and sternocleidomastoid muscles during inspiration. An x-ray of the chest shows flattening of the diaphragm and increased radiolucency in the lower lung fields. Further analysis shows increased activity of an isoform of elastase that is normally inhibited by alpha-1-antitrypsin. The cells that produce this isoform of elastase were most likely stimulated to enter the site of inflammation by which of the following substances?? A: High-molecular-weight kininogen, B: Lactoferrin, C: Interferon gamma, D: Leukotriene B4, E: Thromboxane A2,  <response>: This is a clinical vignette describing a 38-year-old male smoker with a 2-year history of cough and worsening shortness of breath. Key findings include accessory muscle use during inspiration, flattened diaphragm and increased lung radiolucency on x-ray, and increased activity of an elastase isoform normally inhibited by alpha-1-antitrypsin. This suggests a diagnosis of emphysema secondary to alpha-1-antitrypsin deficiency. The question asks which substance likely stimulated the cells producing the elastase isoform to enter the site of inflammation. Leukotriene B4 is known to be a potent chemoattractant and activator of neutrophils, which produce elastase. The other answer choices do not have significant roles in neutrophil recruitment and activation.D: Leukotriene B4 