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FFAs also indirectly cause mitochondrial injury by inducing lysosomal permeabilization, which causes activation of pro-apoptotic members of the Bcl-2 family that subsequently induce mitochondrial permeabilization and apoptotic cell death [70, 71]

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Barton, the discussant, praised the trials rigorous methodology and proposed that there may have been several reasons for the lack of ALC benefit in preventing neuropathy, despite compelling earlier data