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Evidence suggests multiple interrelated pathways of liver injury: Nicotine-induced injury : Nicotine is metabolized in the liver via CYP2A6, where it activates 7-nicotinic acetylcholine receptors (7-nAChR), leading to oxidative stress, mitochondrial dysfunction, and pro-fibrotic signaling [36, 125, 126]

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Biomolecules 11(2) Orem A et al (2001) Effect of coronary angiography on plasma endothelin-1 and nitric oxide concentrations

Before the bout could be made, Galento was required to undergo a more extensive pre-fight physical, which may have been a way for promoters and the state boxing commission to cover themselves in the event that Galento was seriously hurt or even killed