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CD8 + T lymphocytes can upregulate perforin expression and increase MMP activity, resulting in the airway and lung tissue destruction, as well as chemotactic activation of inflammatory cells through secretion of cytokines such as interferon, IL-12, TNF- and chemokines, exacerbating the inflammatory response

Concerns were raised about a potential rise in fake pills, leading the NPA to advise patients to only obtain the drug through regulated pharmacies after a thorough consultation