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Sterile techniques and certified products reduce these risks significantly

Yet, the etiology appears to be multifactorial, as a number of other causative factors have been suggested for KBD, including fungal toxins in grain, iodine deficiency, and contaminated drinking water (52)

7,8 Another study on adapalene compared to placebo did note that adapalene 0.3% gel improved the appearance of skin texture and atrophic scars by 50% and 80% respectively

These studies highlighted reduced expression and inhibition of HIF-1 activity and subsequent reductions in expression of key glycolytic enzymes (e.g., Glut1, PDK, pyruvate kinase M2 [PKM2], lactate dehydrogenase a [LDH], and hexokinases) as major drivers of this metabolic plasticity (179, 180, 182)

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