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Combined these results indicated that NP4 catalyzes the generation of H 2 O 2 in tumor cells, which diffuses outside the cells and activates macrophages, thereby triggering immune responses

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DA has been found to promote cellular iron accumulation and enhance oxidative stress responses in macrophages [108]

While no single direct mechanism has been definitively established, fatigue likely results from multiple factors including substantial caloric restriction, gastrointestinal side effects, dehydration, and metabolic adaptation during weight loss

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