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Description

Johns Wort is an herbal supplement known to induce CYP3A4, potentially reducing fluticasones effectiveness

This process entails the adhesion of the peripheral immune cells to endothelial cells, which facilitates their translocation across the blood-brain barrier, ultimately resulting in barrier disruption, cerebral edema, and brain injury, which indirectly promote the infiltration of peripheral immune cells (69)

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This also indicates the possibility that the inflammatory phenotype raises the risk for the development of myocarditis upon exposure to additional, yet unknown risk factors (200)