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Additionally, complications associated with conception, placenta, embryo, and fetus development, fetal size, and perinatal complications are influenced by these factors (Bodnar et al., 2017)

A secondary level of evidence supports the involvement of EV-associated DAMPs and alarmins, notably HMGB1 and ATP-P2X7R axis, which are well-documented in sustaining chronic inflammation, activating NF-B, and TLR2/4 signaling pathway, and remodeling the tumor microenvironment (Foelsch et al., 2024

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