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CS-induced oxidative stress is responsible for altered cellular metabolism, including increased infiltrating immune cells, pro-inflammatory cytokine production, proteaseantiprotease imbalance, lipid peroxidation, apoptosis, upregulation of unfolded protein response (UPR), and protein misfolding

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Another layer here is that smoking affects testosterone levels indirectly by stressing out your adrenal glands, which are responsible for managing your bodys hormone response

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