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It has been shown to upregulate pathways tied to collagen and glycosaminoglycan synthesis, modulate metalloproteinase (MMP) and tissue inhibitor of metalloproteinases (TIMP) balance, and support antioxidant effects, thereby contributing to matrix organization and structural stability in research settings

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By comparison, the DPP-4 inhibitors, saxagliptin and alogliptin, carry a regulatory warning about the finding of an increased risk of hospitalization for heart failure in treated patients enrolled in large-scale trials carried out with these drugs [57]