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HLA-DR2 dose effect on susceptibility to multiple sclerosis and influence on disease course

157 We posit that for high affinity metals, notably Cu II (and Cu I ), Zn II and Ni II , affinities are so tight so as to render metal dissociation rates (off-rates), even if increased by the presence of metal-buffering small molecules, far too slow to be relevant during intermolecular metal transfer (Figure 34, top )

For some patients, a combination approach may be appropriate using injections during intensive weight management phases and oral supplementation for maintenance