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TB4 has been associated with decreased active radical formation, antioxidative effects, and reduced tissue fibrosis (scar formation) [23]

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The activation of these events leads to increased vasoconstriction and atherosclerosis, ultimately promoting a pro-thrombotic state ( 2 ), and down regulation of endothelioum-dependent hyperpolarization (EDH) and factors that cause contraction such as thromboxane A 2 (TxA 2 ) and upregulation of endothelin-1 (ET-1)

Patients are often advised to start treatment at the first sign of an outbreak to maximize effectiveness