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When NF-B has been released from the IB protein, it is activated and translocates to the nucleus, where it binds to specific DNA sequences called response elements (RE) and expresses the production of proteins and enzymes that cause changes in the physiological metabolism of the cell [190], such as in the inflammatory, immune, and survival responses and the cell proliferation response [191]

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Additional useful auris-acceptable formulations or compositions include one or more anti-aggregation additives to enhance stability of otic formulations or compositions by reducing the rate of protein aggregation

This occurs because unabsorbed carnitine in the gut can be metabolized by intestinal bacteria into a compound called trimethylamine (TMA), which is then excreted through sweat and breath

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