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The upregulation of COX-2 promotes the synthesis of PGE2, which increases vascular permeability and facilitates immune cell migration to local tissues [283]

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Youssef commented that it is known that obesity affects lung function and does make obstructive lung disease such as COPD and asthma much more difficult to control, and so it is not yet clear if the effect of the drug had to do with the weight loss and its effect on COPD, or it had a different mechanism of action