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Consistent with an induction of oxidative stress condition, metformin increased mRNA levels of the master redox transcription factor Nrf-2 (nuclear factor erythroid-derived 2-like), as well as transsulfuration enzymes cystathionine beta-synthase and cystathionase and GSH synthesis enzymes -glutamylcysteine synthetase and glutathione synthetase

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As such, understanding these immune mechanisms is essential when evaluating patients with chronic neuroinflammatory presentations and unexplained toxic burden

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