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Acidic pH impairs the activity of the mitochondrial L-2-HG removal enzyme L-2-hydroxyglutarate dehydrogenase (L2HGDH) and enhances the protein stabilization of HIF-1, leading to its escape from the degradation pathway 90

The mentioned risks are rare but serious

This approach has been shown in patient surveys to reduce soreness, bruising, and the development of injection-site nodules over the course of treatment

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