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E-cigarette use and the irreparable damage caused may additionally cause a vicious cycle where patients may experience frequent exacerbations despite maintaining adherence to their inhaled treatments due to its inhibitory effects in normal lung processes

Another major limitation is the lack of standardized protocols for carotenoid intake or supplementation

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Evidence remains limited and more robust studies are required

Therefore whether the process of ferroptosis regulation, even its intervention efficiency in clinical practice, is impervious to this heterogeneity should also be considered in future studies