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During early protocol, MMP-9 may temporarily rise (breaking down damaged tissue)

USA 105 , 22322237 (2008)

For example, plasma exosomal vesicle levels are elevated in patients with antiphospholipid syndrome, activating endothelial cells, exhibiting pro-inflammatory and pro-coagulant effects, directly interacting with cell receptors, and transferring biomaterials to form thrombotic emboli, promoting the development and progression of RM (tok et al., 2021)