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EV-associated Nef impairs the bloodbrain barrier, induces oxidative stress, promotes Alzheimers-like pathology, and contributes to axonal degeneration, whereas EV-associated Tat directly causes neurite shortening and neuronal death [59, 139, 148,149,150,151]

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Ethics approval and consent to participate The medical ethics committee of the Maastricht University Medical Center+, the Netherlands approved the TearAD study (identifier: NL73600.068.20/METC 20033), and all participants provided written informed consent