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They prevent the breakdown of NO-derived cGMP in vascular smooth muscle cells by competing with cGMP for the PDE5 catalytic site

J Cell Biol 191:677691 Wang Y, Wysocka J, Sayegh J, Lee Y-H, Perlin JR, Leonelli L, Sonbuchner LS, McDonald CH, Cook RG, Dou Y (2004) Human PAD4 regulates histone arginine methylation levels via demethylimination

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These complications are often linked to improper techniques or insufficient supervision