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However, simply showing that the enzyme can cleave a substrate in vitro does not necessarily mean that DPP-4 plays an important physiological role in regulating concentrations and/or modulating biological activity of the endogenous molecules, particularly in humans and, for many of these putative substrates, there is little, if any experimental evidence to show that DPP-4 does actually cleave them in vivo and/or whether this has any physiological consequence

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Damage to or removal of the lymph nodes in your body are the most common causes of lymphedema