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Shoemaker's research demonstrated that patients with CIRS consistently show severe abnormalities in inflammatory blood markers, including highly elevated TGF-beta1, C4a, and MMP-9, alongside drastically depleted levels of Melanocyte Stimulating Hormone (MSH) and Vasoactive Intestinal Polypeptide (VIP)

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In DN, persistent hyperglycemia is known to augment OS, thereby contributing to nerve damage and dysfunction