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In vivo , receptor-targeted SPIONs accumulate intracellularly, as confirmed by Prussian blue staining, and demarcate infiltrative margins unseen with conventional agents (137, 138)

This process liberates NF-B dimers, enabling their nuclear translocation and subsequent binding to target gene promoters, thereby activating transcription of a broad array of inflammation-related genesincluding pro-inflammatory cytokines (e.g., TNF-, IL-1), anti-apoptotic molecules (e.g., Bcl-xL), and inflammatory enzymes (e.g., cyclooxygenase-2, COX-2)ultimately contributing to immune defense, cell survival, and amplification of inflammatory responses [211, 212]

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The second level of risk, mainly for peptides from the black market, is that consumers do not know exactly is in the vial they are buying