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If a patient develops severe joint pain discontinue the DPP-4 inhibitor

In vitro, many peptide hormones and chemokines are susceptible to DPP4 cleavage when incubated with DPP4 at high concentrations [25,45]

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The WGS data revealed the integration of a marker resistance gene, the deletion of the endogenous rib operon, and the presence of four putative recombinant pBR322 and pUC-based plasmids harboring additional rib operons