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Immunol Rev 235:93104 Lin Y, Liu H-L, Fang J et al (2014) Anti-fatigue and vasoprotective effects of quercetin-3-O-gentiobiose on oxidative stress and vascular endothelial dysfunction induced by endurance swimming in rats

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Additional mechanisms attributed to berberine in laboratory and animal studies include modulation of gut microbiota composition, inhibition of mitochondrial complex I, and effects on various signaling pathways including those involving insulin receptor substrate proteins