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Ethyl pyruvate is a small molecule derivative of the endogenous metabolite pyruvic acid. It has been investigated primarily as an anti-inflammatory and tissue-protective agent in various preclinical models of critical illnesses, including sepsis, acute pancreatitis, ischemia-reperfusion injury, renal injury, endotoxemia, and stroke. Ethyl pyruvate acts by inhibiting the systemic release of pro-inflammatory cytokines such as Tumor necrosis factor alpha and High mobility group box 1 protein, which are implicated in severe organ damage during critical care conditions. Its mechanism also involves modulation of redox processes and cellular metabolism; it may provide exogenous pyruvate to fuel cell metabolism and influence energy production through activation of Nuclear factor erythroid 2-related factor 2 signaling pathways. Ethyl pyruvate has demonstrated safety in human volunteers at clinically relevant doses but remains investigational for therapeutic use[1][2][3][4][5][6].
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