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The upregulation of Bcl2 , Akt , and other anti-apoptotic genes, combined with the downregulation of Bax and Bcl-xL, which are pro-apoptotic genes, can increase tumor cell resistance to chemotherapy ( TP53 gene mutations also impair the functional efficacy of anticancer drugs, in addition to inhibiting the activation of apoptosis

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It is hypothesized that microplastics may disrupt the epithelial barrier and alter immunological responses (117)