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In the intrinsic pathway, ROS-mediated mitochondrial damage is the core triggering factor, while pro-inflammatory factors not only directly induce apoptosis through the extrinsic pathway but also exacerbate ROS accumulation by inhibiting the activity of mitochondrial respiratory chain complexes, accelerating the progression of the intrinsic apoptotic pathway
The studies' sample sizes were small, however, and had short follow-up periods, leaving longer term outcomes and risks unknown
The primary risk is receptor downregulation if gaps exceed 57 days, which may slow pigmentation progression and require an extra 12 weeks to reach plateau
Limited clinical evidence supports simultaneous use, and the combination carries risks including elevated blood pressure, heart rate changes, and compounded gastrointestinal side effects
(1462-8902),14(3), p
The core difference is regulatory status, not chemistry
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