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Damage to the tubular endothelial cells can increase leukocyte adhesion, platelet aggregation, and vasoconstriction, reduce blood flow to nephrons, and damage the glomerular barrier and the extensive network of peritubular capillaries (88)

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The authors pose that the expression of hypoxia-inducible factor 1 alpha in intestinal epithelial cells represents a crucial check point for the development of arthritis by impeding necroptosis of intestinal epithelial cells and safeguarding the intestinal barrier integrity