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It might be that the oxidative stress level was increased which further activated the advanced glycation end product (AGE) and receptor for advanced glycation end products (RAGE) in CS-induced endothelial cells and circulating CS directed toxicity on endothelial cells

In a genome-wide DNA methylation analysis of peripheral blood mononuclear cells by Dogan et al., it was found that methylation levels of genes implicated in inflammatory and immune function pathways were altered by cigarette smoking, which could consequently cause complex illnesses with inflammatory components (152)