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Despite this steady progress, one of the most challenging health problems of the 21st century remains the dramatic increase in diabetes mellitus that is occurring throughout the world

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These observations suggest that D-lactate could potentially act as an agonist on TLR2 and TLR9 receptors, increasing the inducible nitric oxide synthase (iNOS), TNF- , and IL-12, thereby exerting influence over the polarization of macrophages towards a pro-inflammatory phenotype (134)

Song, J., Park, S.-Y