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When the peptide binds to these receptors in fat tissue, it triggers a cascade that increases lipolytic enzymes, breaking down stored triglycerides into free fatty acids for energy use

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45, 46, 47 Endotoxins are highly toxic lipopolysaccharides (LPS) of the outer cell wall of Gram-negative bacteria

These seemingly paradoxical effects may be one explanation for why patients with G6PD-d display increased susceptibility to infection indicative of an impaired immune response, while also displaying increased autoimmunity and inflammation indicative of an overactive immune system 13