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Key regulators such as HIF-1 and PPAR- act in opposition to fine-tune this balance: HIF-1 activation, even under normoxic conditions, promotes glycolysis and can inhibit mitochondrial respiration, whereas PPAR-, upregulated by signals like IL-4 and GM-CSF, enhances lipid uptake and oxidation while antagonizing inflammatory glycolysis

For severe cases, treatments might be needed weekly or bi-weekly during the most symptomatic period