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Smoking also induces apoptosis of lymphocytes, increases CD8+ cytotoxic T cells, decreases CD4+ cells, and impairs natural killer cell activity [21, 22]

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These pathways are relevant to research on tissue repair mechanisms in muscles, tendons, ligaments, bone, and gastrointestinal tissues [1,6,11]

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Third, most studies were designed to measure efficacy of healing, not to conduct rigorous, long-duration toxicology and carcinogenicity assessment following regulatory standards