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274,275 This, in turn, diminishes additional downstream effects, including oxidative stress, the secretion of pro-degradative substances, modifications to cell phenotype (hypertrophy, M1/M2 macrophage phenotype, fibrosis), and damage or deterioration of joint cells (apoptosis, senescence)

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VRAs employer institution has received research funding for her role as investigator on clinical trials from Applied Therapeutics, Medpace, Eli Lilly, Fractyl, Premier, Novo Nordisk and Sanofi