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Concurrently, increased expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) within uterine fibroid tissue inhibits matrix metalloproteinases (MMPs) activity, resulting in reduced degradation of the ECM and exacerbating its excessive deposition [98]

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Chatzistergos (2024) demonstrated that the high variability imposed by Hoyt and Schatten (1993) is inconsistent with direct TSI measurements and that a variability magnitude approximately five times smaller is required