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Nevertheless, although a specific action of homocysteine seems to occur at low concentrations, experimental trials have been conducted only with homocysteine administration, which would reflect a severe hyperhomocysteinemia rather than a more physiologic moderate elevation of circulating homocysteine, and clinical observations have only come from homocystinuric patients with severe hyperhomocysteinemia
However, the complex machinery underlying CIPN is poorly understood
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