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The authors reported that high intracellular levels of the lactone caused apoptotic cell death by upregulation of COX-2 mRNA and protein, as well as increased formation of peroxisome proliferator activated receptor (PPAR)-activating PGD2

316,317 Some centers are attempting to integrate ablation technology with immunotherapy or other targeted inhibitors to harness these treatments synergistic effects and safely activate the immune system, which could be pivotal in further enhancing long-term prognosis

Dash SR, Kundu CN

Key quality indicators to look for include third-party testing with certificates of analysis (COA) showing purity above 98%, proper lyophilization (the powder should be a clean, white cake, not a yellow or clumpy mass), appropriate packaging (amber vials to protect from light degradation), and clear labeling including peptide identity, mass, lot number, and expiration date