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Furthermore, evidence from diabetic rats and cultured mature adipocytes demonstrated that fumarate as an electrophile can directly react with GSH and cysteine residues in proteins via a Michael addition reaction forming S-(2-succinyl)-cysteine (succination), supporting the view that fumarate can irreversibly modify GSH (1, 67)

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Figure 8 Network correlation analysis was conducted on the DEGs and DAMs in these two pathways

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There was also a decrease in the markers for oxidative stress at six months as indicated through an improvement in the oxidized (GSSG) to reduced (GSH) glutathione ratio in whole blood, in conjunction with favorable increases in natural killer cell cytotoxicity