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10.1016/j.msec.2019.03.095 4 AlaviM.NokhodchiA

Macrophages will use the respiratory burst and production of ROS (Reactive oxygen species), NO (Nitric oxide) and pro-inflammatory cytokines (TNF, IL6, IFN) as ways to kill the pathogen and initiate an adaptive immune response if needed (78)

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The concerns about the adverse effects of non-noble varieties, produced by their undesirable composition of kavalactones and high concentrations of potentially harmful compounds (flavokavains, which are not present in any significant concentration in the noble varieties), have led to legislation prohibiting exports from countries such as Vanuatu