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Persistent synovitis can induce VEGF production, promoting neovascularization and increased vascular permeability (143), which may facilitate the influx of iron into the joint cavity and subchondral bone and recruit additional immune cells, thereby intensifying local oxidative stress and inflammatory cascades (144)

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The synthesis of research citations grounded the discussion in scientific evidence, supporting the analysis with empirical data and pointing to areas where further investigation is needed