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This disruption is often a result of the release of inflammatory cytokines, oxidative stress, and matrix metalloproteinase (MMP) activation

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Once translocated into systemic circulation, LPS activates toll-like receptor 4 (TLR4), triggering NF-B-mediated release of proinflammatory cytokines ( e.g ., TNF-, IL-6) and further aggravating insulin resistance and ovarian inflammation (69)