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These same strategies may be ineffective when elevated SAH, adenosine accumulation, toxic burden, creatine demand or impaired clearance is the main bottleneck

The upregulated Pt transporters [e.g., organic cation transporters (OCTs), multidrug and toxin extrusion proteins (MATEs), and copper transporters 1/2 (Ctr1/2)] in DGR increase the accumulation of Pt drugs in peripheral nerves as the first step to induce PIPN (Sprowl et al., 2013

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