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Additionally, rotenone upregulates p53 and COX2, inhibits ChAT, GPX4, and SLC7A11 activity, induces ferroptosis and cholinergic dysfunction, and causes neuronal dysfunction (Huang et al., 2022)

Protection against electrophile and oxidant stress by induction of the phase 2 response: Fate of cysteines of the Keap1 sensor modified by inducers

That means patients need sufficient protein, progressive resistance training, adequate micronutrients, and a plan that does not push them into excessive under-eating