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Estrogen-responsive element (ERE) in the Nrf2 promoter region can also be directly activated by ER to promote Nrf2 transcription [190]

Its actions, however, are highly context-dependent, and under conditions of NAD + depletion, specific cell types, dosing imbalances, or advanced disease, SIRT1 may exacerbate oxidative damage by impairing repair enzyme activity, exacerbating mitochondrial dysfunction, and weakening antioxidant responses

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