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This risk may be compounded by the unregulated manufacturing and distribution of peptides in the gray market, where purity and sterility cannot be assured. Long-Term Effects Finally, the long-term effects of many peptides remain poorly understood

Mice deficient in endothelial NO synthase (eNOS), the key enzyme for NO production in vessels, are characterized by faster erythrocyte clearance, possibly due to enhanced erythrocyte PS exposure and subsequent phagocytosis [170]