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As a core metabolic product, lactate may promote the release of inflammatory mediators (e.g., IL-6, TNF-α) by activating the TGF-β signaling pathway, while enhancing NF-κB pathway activity to exacerbate local inflammatory infiltration in lung tissue — but this direct activation has not been demonstrated in COPD airway cells

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Sialorrhea: a review of a vexing, often unrecognized sign of oropharyngeal and esophageal disease