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Major barriers to the clinical use of gene therapy, however, include transfection efficiency, the creation of long-term effects, the difficulty of controlling cell proliferation, ectopic transfection, disease transmission, patient-specific dose responses, immune reactions against viral proteins, possible side effects, and ethical issues [87, 88]

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Target levels above 400 pg per milliliter

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Whether dealing with a specific injury like a rotator cuff strain or a chronic condition like tendinopathy, the evidence base supports potential benefit