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To account for the continuing degeneration and atrophy in later stages, in the face of waning adaptive inflammation as the disease progresses, it has been proposed that the inflammation becomes trapped behind the bloodbrain barrier, continuing to damage the CNS, but now being inaccessible to peripherally-administered immunosuppressants

And then with early or late NAC therapy

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10.1016/j.jacc.2020.11.044 39 GettingerS.LynchT