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Sorbitol, unlike glucose, cannot pass efficiently through cell membranes and therefore remains trapped inside the cells, increasing osmolality, resulting in swollen cells due to water retention
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References Porsbjerg C, Melen E, Lehtimaki L, Shaw D, Asthma (2023) Lancet 401(10379):858873 Diseases GBD, Injuries C (2020) Global burden of 369 diseases and injuries in 204 countries and territories, 19902019: a systematic analysis for the global burden of disease study 2019
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