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This unique exposure pattern caused: The combination of tobacco smoke and asbestos in Kent lung tissue created an especially hazardous scenario, as cigarette toxins weakened the lungs natural ability to clear foreign particles while asbestos fibers accumulated in respiratory tissue

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Smoking also induces expression of immune checkpoint proteins like PD-L1 on tumor cells, which inhibit the activity of cytotoxic T lymphocytes by engaging PD-1 receptors, leading to immune exhaustion

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