Interestingly, we found that rapidly progressing VS cases exhibited activation of several pathways linked to viral infection, such as the canonical pathway NF-κB Activation by Viruses, and others highlighted in Fig. 3C. These findings may indicate that fast progressing VS are associated with an underlying viral infection, which is associated with the dramatic upregulation of stress-related and proliferation/survival signaling pathways, as well as the significant downregulation of immune signaling. This evidence concerns the gene NFKB1 and viral infectious disease.