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There are four isoforms of the p38 family of MAPKs (, , and ), which have a key function in transducing extracellular signals from outside the cell into the nucleus, through a series of phosphorylation events, ultimately activating effectors of gene expression
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Combined use demands regular monitoring of liver function, lipase, and blood glucose, especially in patients with history of pancreatitis, personal/family thyroid cancer, or unstable renal function