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This sophisticated crosstalk, where parallel pro-apoptotic pathways (ATF4-driven induction and CHOP-mediated fine-tuning) converge on the CHAC1 promoter, allows for precise control of cell fate under prolonged ER stress (Nomura et al., 2020)

Some patients experience oscillating side effects (nausea in week one, increased hunger in week two) when dosing is irregular, making the treatment harder to tolerate and less effective

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