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RhlI and RhlR are primarily responsible for the synthesis and detection of N-butanoyl-L-homoserine lactone (C4-HSL), which also promotes the transcription of RhlI, which in turn promotes the expression of virulence factors [79]

However, it is now believed that while cell senescence initially acts as a robust barrier against tumor initiation, the subsequent accumulation of senescent cells can paradoxically promote cancer recurrence and cause damage to neighboring tissues

This paradoxical improvement occurs because pain reduction outweighs any stimulatory effect on neurotransmitters