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The reduction of SIRT4 affects mitochondrial fusion and fission and reduces ATP synthesis, leading to mitochondrial dysfunction and the large amounts of ROS, thereby enhancing renal oxidative stress in db/db mice and promoting the development of DKD (Liang et al., 2023)

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Osteoarthritis in 2020 and beyond: a Lancet Commission

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Sabouraudia, 13: 148-153

The logic is that local administration creates higher peptide concentrations at the relevant tissue