Under normal conditions, TNF- is present at low levels in squamous epithelial cells, but its expression is markedly elevated in the esophageal and gastric mucosa of GERD patients
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Tumor cells, tumor-associated macrophages, and certain dendritic cells can decrease local tryptophan levels by provoking metabolic enzymes, including indoleamine 2,3-dioxygenase (IDO1) and tryptophan 2,3-dioxygenase (TDO2) (130)