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They contain high levels of hydroquinone and or kojic acid

Environmental triggers, such as stress, infections, smoking, and iodine intake, also play significant roles in triggering or exacerbating the autoimmune response in susceptible individuals

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5.2.2 Pulmonary arterial hypertension (PAH) model PAH is a gradual and fatal condition indicated by intensified respiratory vascular resistance, causing right ventricular hypertrophy and eventual cardiac failure [248]