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However, in addition to the effects described above there are well-documented increases in alveolar oxidative stress 53,58,73-77 and decreased antioxidant levels, 54,55,59,78,79 impairment of surfactant protein D (SP-D) structure and function, 80-82 reduced secretion of antimicrobial peptides, 83-85 impaired transport of IgA into alveolar space, 86 changes to the metabolic profile, 87-89 and alterations in the pulmonary microbiota

Notably, it has been observed that expression levels of activation genes in dermal papilla cells are significantly decreased when these cells are grown in cell culture conditions 12

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Kevin Ii, Meujo, & Hamann, 2009