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This intensified activation increases gastrointestinal side effects

At the vascular and interstitial scale, insufficient perfusion and dense stromal architecture limit the ability of nanocarriers to enter tumor tissue and access deeper regions, making enhancement of functional perfusion and penetration a primary design concern [31, 33, 36]

Killip, S., Bennett, J

(Albin 2022) There is no hard maximal dose

At the same time, this process will influence the function of intestinal immunity and will lead to the deposition of pigment on the mucosa.31 The long-term use of laxatives can cause epithelial cell damage, and the disruption of mucosal integrity triggers the release of immune competent cells, such as mast cell, in turn leading to the deposition of pigment on the mucosa.32 Direct toxic effects of drugs on epithelial cells are involved in the pathogenesis of MC It has been concluded that anthraquinone laxatives would have direct toxic effects on colonic epithelial cells, which tend to produce lipofuscin, engulfed by nearby macrophages and then generate brown or black pigments.3 It has been suggested that anthraquinone laxatives produce toxic substances in the large intestine, where they damage epithelial cells.31 These substances alter the functions of normal cellular absorption, secretion and proliferation by inducing apoptosis, reducing the number of mucosal crypts and increasing cell proliferation

De vervanging van methionine door norleucine (Nle) op positie 4 voorkomt oxidatieve degradatie, terwijl de introductie van D-fenylalanine op positie 7 in plaats van het natuurlijke L-fenylalanine de binding aan melanocortinereceptoren significant versterkt