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In addition, PYC suppresses adipose differentiation-related protein, which is involved in atherosclerosis development and highly expressed in macrophages ( In an in vitro study on microglial cells, PYC dose-dependently decreased the release of nitric oxide, tumor necrosis factor- (TNF-), interleukin (IL)-6, IL-1, ICAM-1, and perilipin 2, thereby exhibiting anti-inflammatory activity ( Ex vivo analysis of plasma from volunteers following PYC administration revealed moderate inhibition of COX-1 and COX-2 activity, indicating potential anti-inflammatory and platelet-inhibitory effects (Schfer et al., 2006)

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Despite limitations related to the clinical heterogeneity of the studies, particularly regarding the type of maintenance, the authors concluded that there was no significant difference in OS between the strategies

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