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The 2021 meta-analysis found a relative risk of 3.66, but the 95% confidence interval stretches from 1.09 to 12.25

RA synovial fluid, rich in TGF-, has been demonstrated to induce -SMA expression in adipose-derived mesenchymal stromal cells (MSCs) via Smad2 signaling, indicating TGF-s pivotal role in fibrotic phenotype progression (109)