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At the same time, pyruvate accumulation stabilizes and activates hypoxia-induced factor-1α (HIF-1α) (even in the body’s physiological oxygenated state) which increases oxidative stress and induces an inflammatory response in the form of, for example, activation of nuclear factor kappa-B (NF-κB) and increased expression of tumor necrosis factor-α (TNF-α) [60,61] (Figure 3)
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