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Overall, in ALS the adaptive immune system appears to have a dual role: a well-regulated adaptive response dominated by Tregs and possibly Th2 cells may be neuroprotective, whereas a shift toward pro-inflammatory adaptive immune response with high concentrations of Th1/Th17 and cytotoxic T cells likely exacerbates neurodegeneration (114, 115)

But generally, most providers and manufacturers recommend keeping insulin syringes in the refrigerator

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Suzuki, N., Koussevitzky, S., Mittler, R