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CS is associated with greater levels of inflammatory markers such as interleukin (IL)-6, C-reactive protein (CRP), and tumor necrosis factor (TNF)-in smokers in both sexes (32, 33)

the majority of collagen is not fibrillar and appears to be degraded, an observation consistent with gene array analysis showing a decrease in expression of tissue-inhibitor metalloproteinase 1 (TIMP1), an inhibitor of matrix metalloproteinases