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This defective desquamation prevents normal debridement resulting in excessive growth and thickening of the filiform papillae that then collect debris, bacteria, fungi or other foreign materials which contribute to the discoloration

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Although metabolic shift from OXOHOS to glycolysis of less efficient ATP production has been reported during myofibroblast differentiation [42], mitochondrial morphological alterations remain unclear in IPF lung fibroblasts