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A parallel line of work by Chang and colleagues (J Appl Physiol, 2011) examined cultured rat Achilles tendon fibroblasts and reported increased outgrowth, survival and migration alongside elevated phosphorylation of focal adhesion kinase (FAK) and paxillin, the adaptor pair coupling integrin engagement to cytoskeletal reorganisation

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Stage 2: Decreased levels of B12 and metabolic abnormalities such as high homocysteine or methylmalonic acid (MMA) levels