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These alterations can result in a release of inflammatory mediators and cytokines with subsequent macrophage activation, polymorphonuclear (PMN) cell recruitment, inflammation, and tissue damage (64)

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Chronic alcohol consumption upregulates CYP2E1, 40 promoting ROS production in hepatocytes and nicotinamide adenine dinucleotide phosphate oxidase 4 overexpression

In KOA, this balance is disturbed, resulting in an increased rate of degeneration

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