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This persistent inflammatory state is not merely a passive association but an active driver of pathology in both muscle and vasculature, creating a self-reinforcing cycle of tissue degeneration (66, 67)

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2 Methods 2.1 Study participants and ethics statement Healthy asymptomatic donors from Brazil ( n = 5, males and females) and two independent cohorts of donors from North America ( n = 4 and n = 3, males and females) with remote latent TB infection (LTBI) were recruited into a volunteer study (age range: 2565 years)