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Pyroptosis is initiated by the cysteine protease caspase-1, which is activated via inflammasome assembly in response to pathogen- or damage-associated signals 3,4

While there is now little doubt that a degenerative process operates not only in the later progressive phase of the disease, but also likely from the earliest stages of relapsing inflammatory presentations, what is fiercely debated is whether a primary autoimmune inflammation also drives the continuing CNS cytodegeneration and CNS atrophy (Sen et al., 2020

More importantly, glutamine metabolism is also regulated by tumor suppressors

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