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Increasing evidence indicates that high mobility group box 1 (HMGB1), a nuclear protein released from dendritic cells, macrophages, and necrotic cells during inflammation, plays an important pathological role in DKD by activating TLR2 and TLR4 signaling (195)

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The difference is regulatory oversight: compounded peptides do not undergo the full FDA approval process for finished drug products, meaning batch-to-batch consistency and potency verification are managed by the pharmacy rather than the FDA