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Pro-inflammatory adipokines (e.g., leptin, resistin) and adipose-derived exosomes (carrying miRNAs like miR-3074-5p) create a chronic inflammatory joint microenvironment by polarizing synovial macrophages toward an M1 phenotype and inhibiting anti-inflammatory adiponectin (16–18)
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Macropinocytosis facilitates albumin uptake into epithelial cells, where the protein is degraded and subsequently secreted 17,54
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