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66 Cultured fibroblasts respond to AN extract or arecoline in vitro, and experience differentiation into cells that exhibit features of MFBs including -SMA expression and collagen gel contraction, and other fibrosis marker expression, such as CTGF

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Second, we acknowledge the observational nature of our experimental approach that, at the moment, precludes answering some salient mechanistic questions, such as factors leading to the decline of the systemic levels of dopamine, glutamate, and BDNF