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Pro-inflammatory cytokines such as TNF- and IL-6 downregulate transcription of BCAA metabolism-related genes and impair BCAA oxidation by activating BCKDK to increase phosphorylation (inactivation) of BCKDH ( On the other hand, accumulated BCAAs and their metabolic products can activate inflammatory pathways, exacerbating inflammatory responses

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Regulatory status : In most cases, IV fluids, including several injectable products containing vitamins, are regulated by the TGA