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The first stage is Trem2-independent and involves a reduction in homeostatic microglia checkpoint genes such as Cx3cr1, P2ry12 , and P2ry13 , along with upregulation of genes including the Trem2-signaling adaptor Tyrobp, Apoe , and B2m
It is important to note that these studies focused on off-label use, and the FDA has not approved Topamax specifically for weight loss
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