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These effects drive inflammatory processes and nitro-oxidative pathways [100] and the resultant excess of reactive oxygen species may induce oxidative damage, aggravating systemic tissue damage and contributing to more severe COVID-19 [101]

In theory, combined use may be complementary, but individual responses vary

Research endpoints include epithelial-barrier integrity, cytoprotective signaling, inflammatory-response markers, peptide biodistribution, and comparisons with parenteral delivery models

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