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Reactive oxygen species (ROS) and cellular redox systems represent a fundamental biological framework responsible for maintaining the balance between oxidative signaling and oxidative stress. ROS, including superoxide anions, hydroxyl radicals, and hydrogen peroxide, are natural byproducts of aerobic metabolism and serve as essential secondary messengers in pathways such as cell growth and immune response (Sies et al., 2017, Nature Reviews Molecular Cell Biology). To prevent damage to cellular components, organisms utilize a sophisticated redox system comprising enzymes like superoxide dismutase (SOD), catalase, and the glutathione/thioredoxin systems (Holmgren, 1985, Annual Review of Biochemistry). Chronic imbalance, or oxidative stress, is implicated in the pathogenesis of cancer, neurodegenerative disorders like Alzheimer's, and cardiovascular diseases (Halliwell, 2006, Lancet). Therapeutic strategies targeting these systems include the use of antioxidants to scavenge radicals or small molecules like dimethyl fumarate that activate the Nrf2 pathway to bolster endogenous defenses (Liby & Sporn, 2012, Nature Reviews Cancer). However, precise modulation is challenging, as excessive suppression of ROS can interfere with vital physiological signaling and host defense mechanisms.
Drugs targeting these systems typically act through direct scavenging of free radicals, activation of the Nrf2-Keap1 antioxidant response pathway to induce endogenous enzymes, inhibition of ROS-generating enzymes like NADPH oxidase (NOX) or xanthine oxidase, or by replenishing essential thiol pools such as glutathione (Forman & Zhang, 2021, Nature Reviews Drug Discovery).
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