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It inhibits NF-κB activity and increases the expression of NF-κB inhibitor, resulting in reduced expression of pro-inflammatory genes responsible for IL-6, IL-8, TNF- α and COX-2, thereby reducing prostaglandin levels (Reference Hassanshahi, Anderson and Sylvester111–Reference Liu, Zhang and Xu113)

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The mechanisms sustaining this heterogeneity are unknown, although it should be acknowledged that CVOTs lack the statistical power to reliably detect differences in specific MACE components