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Damaged AECs release pro-inflammatory and pro-fibrotic mediators, including interleukin (IL) -1 and tumor necrosis factor (TNF) -, which promote fibroblast recruitment, inflammatory cell activation (e.g., neutrophils, Th17, gdT cells), and myofibroblast differentiation, ultimately leading to ECM accumulation and fibrotic tissue remodeling [20, 29, 33, 34]

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Pi-Sunyer et al., 2015

21% of the exposures were related to errors on initial use of the pen

Over time, this can lead to: Loss of lean body mass and lower resting metabolic rate Reduced protein intake , making it harder to maintain muscle Micronutrient deficiencies , particularly vitamin D, calcium, magnesium, and B-vitamins Lower energy levels and slower recovery from illness or exercise (Mozaffarian, 2025) Gastrointestinal side effects can make the picture even more complex

OSA coverage pathway continues with same criteria