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Therefore, a combination of transcellular and paracellular routes for crossing the nasopharyngeal barrier is also possible if the meningococci crossing via the transcellular route induce a sufficient level of inflammation to alter epithelial permeability, allowing other bacteria to follow the paracellular route

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[22] [23] Pioglitazone , a diabetes medication, has also shown benefit in some patients with biopsy-proven NASH, but its use should be specialist-supervised and limited to selected cases