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Hepatic cytochrome P450 isoenzymes CYP1A2 and CYP3A4 mediate N-de-ethylation, so polymorphisms or competitive inhibition at these pathways (e.g., by certain antidepressants or azole antifungals) may increase systemic exposure, underscoring the importance of individualizing dosage and monitoring serum concentrations in prolonged infusions

Environmental exposure, estrogen and two X chromosomes are required for disease development in an epigenetic model of lupus

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