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The involvement of oxidative stress mechanisms in DC activation and cytokine secretion includes a significant increase in protein oxidationmeasured by the formation of carbonyl radicalsand triggers p38 and extracellular signal-regulated kinase/mitogen-activated protein kinase (ERK/MAPK) signaling, resulting in the upregulation of CD40

In extreme cases, hospitalisation may be required if the patient is unable to eat, is in extreme pain or is severely dehydrated

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