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15 Collectively, these events lead to a vicious cycle of persistent inflammation and chronic oxidative stress, which results in protease-anti-protease imbalance, defects in tissue repair mechanisms, accelerated apoptosis in lung cells and progression of COPD

Injections are delivered into a muscle that contains a rich blood supply

This is the first time the active substance is metabolised in the liver, which is called the first pass metabolism

However, due to the lack of a placebo control and inherent biases of unblinded designs, these findings remain preliminary and insufficient to support clinical use (168)