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Additionally, the exposed group demonstrated significantly higher PLA 2 and SMase enzyme activity, with their median values being 518 and 706 AFU/mg, compared to 267 and 444 AFU/mg in the unexposed workers

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Continuous administration without washout can lead to adaptive downregulationwhere receptors become less responsive to MOTS-c signaling or NNMT inhibition becomes less effective due to compensatory upregulation