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Inhibiting the RAS-RAF-MEK-ERK pathway could reduce FECH activity by downregulating hypoxia-inducible factor (HIF)-1 to enhance PpIX accumulation 28,29

Other chemical species of extracellular Cys are also largely or entirely in oxidized disulfide states (e.g., GSSG or protein-disulfides)

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For patients, this restoration of capillary perfusion may translate to a reduction in deep tissue muscle pain, improved exercise tolerance, and an alleviation of the suffocating fatigue that characterizes tissue hypoxia