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As immune diversity contracts and regulatory networks weaken, inflammatory responses may become less acutely aggressive yet chronically sustained, favoring neurodegenerative mechanisms over overt relapses (58, 91, 92), with recent work further supporting the presence of progression-related immune remodeling consistent with accelerated immune aging in MS ( Smoking-related immune aging may also have implications for therapeutic responsiveness

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J Pharmacol Exp Ther 294 : 458465

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