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They extensively affect multiple tissues and organs accompanied by uncontrolled cytokine storm and delayed interferon-gamma response, multi-organ fibrosis, impaired tissue remodeling, and organ failure [303, 304]
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One possible explanation provided by gene expression data in 2024 suggests that smoking is significantly associated with the upregulation of the cytokine receptor-like factor-1 (CRLF1) gene, which translates to actin alpha 2 (ACTA2+) smooth muscle cells, particularly found in carotid plaques
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