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Indeed, ALT telomeres have a relaxed telomeric chromatin configuration (compared to telomerase positive and normal cells) making them more susceptible to DNA damage and telomere elongation through ALT (Lin et al 2021

Gastrointestinal side effects like nausea are common during dose escalation

doi: 10.2967/jnumed.113.131045 47 MuellerCLinJCSheriffSMaudsleyAAYoungerJW

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One of the major reasons psoriatic arthritis is missed early is because the symptoms dont always arrive together