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However, because IGF-1 promotes cell growth and inhibits apoptosis , it may accelerate the progression of existing or dormant tumors

Conversely, exosomes may also confer resistance to ferroptosis in tumor cells (123)

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This remodeling involves interactions among various cell types, including endothelial cells, smooth muscle cells, and fibroblasts, across the distinct layers of the pulmonary arteries, resulting in histological alterations to the vessel wall (Zhang and Sun, 2021

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