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When homocysteine rises, it can trigger immune cellsespecially monocytes and endothelial cellsto release inflammatory cytokines such as: IL-8 MCP-1 These cytokines recruit immune cells and amplify inflammation throughout the body

Disruption of carnitine homeostasis is also associated with pulmonary vascular endothelial dysfunction, and carnitine supplementation can alleviate this endothelial dysfunction by restoring nitric oxide signaling and reducing reactive oxygen species production [311]

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