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Effects of aminoguanidine, an inhibitor of inducible nitric oxide synthase, on nitric oxide production and its metabolites in healthy control subjects, healthy smokers, and COPD patients

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239,240 This activation increases the expression of proinflammatory cytokines and adhesion molecules, contributing to oxidative stress, inflammation, and vascular dysfunction

options include high-dose oral cyanocobalamin (1,000 mcg daily) or intramuscular hydroxocobalamin injections, with IM injections preferred for confirmed deficiency or neurological symptoms