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It is diagnosed through skin biopsy showing reduced intraepidermal nerve fiber density (IENFD) or corneal confocal microscopy showing reduced corneal nerve fiber density

As detailed in Section PGC-1 coactivators, PGC-1 coactivates transcription factors (NRFs, ERRs, and PPARs) to stimulate the expression of nuclear-encoded mitochondrial genes, thereby increasing mitochondrial mass

But animal studies fail to translate to humans more often than they succeed