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This creates a positive feedback loop where COX-2 activity is further boosted increasing the production of pro-inflammatory prostaglandins, which exacerbate oxidative stress and tissue damage ( COX-2 gene can be implicated in oxidative stress-related conditions such as cancer, cardiovascular diseases, and neurodegenerative disorders

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Notably, the overlap in CFS abnormalities observed across chronic conditions suggests a potential shared pathway of brain dysfunction