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Additionally, immune-related pathways were activated in the long term, with a short-term upregulation of inflammatory markers, such as interleukin ( IL)-6 and IL-18 , although the levels of matrix metalloproteinases (MMPs) remained stable, indicating that not only complex inflammatory stimuli, but also oxidative stress responses can disrupt ECM homeostasis

On the molecular level, human microRNAs (miRNA) have also been identified as potential early biomarkers for indicating APAP-induced hepatotoxicity at a stage before alanine aminotransferases become elevated