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This is achieved through upregulation of enzymes involved in androgen biosynthesis, such as cytochrome P450 family 17 subfamily A member 1, aldo-keto reductase family 1 member C3 and hydroxysteroid 3-dehydrogenase type 1

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The second signal refers to the interaction between the co-stimulatory molecules and their corresponding ligands on the surface of the T cells
