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Reactive oxygen species (ROS) are highly reactive oxygen-derived molecules, including free radicals like superoxide and hydroxyl radicals, as well as non-radicals like hydrogen peroxide [NIH, 2023]. They are primarily generated as byproducts of mitochondrial oxidative phosphorylation or by specialized enzymes such as NADPH oxidases (NOX) [Nature Reviews Molecular Cell Biology, 2020]. At physiological levels, ROS function as essential secondary messengers in signal transduction pathways that regulate cell growth, differentiation, and immune responses [Frontiers in Physiology, 2021]. However, an imbalance between ROS production and the capacity of antioxidant defense systems leads to oxidative stress, causing oxidative damage to DNA, lipids, and proteins [Journal of Clinical Investigation, 2018]. This "local redox state" dysregulation is a central feature in the pathogenesis of various conditions, including cancer, cardiovascular diseases, and neurodegeneration [PubMed, 2022]. Pharmacological intervention typically involves the use of antioxidants to scavenge ROS or the activation of the Nrf2-KEAP1 pathway to enhance endogenous antioxidant expression [PubChem, 2023].
Drugs targeting the redox state typically function by directly scavenging free radicals, neutralizing reactive oxygen species, activating endogenous antioxidant pathways such as the Nrf2-KEAP1 system, or inhibiting enzymes responsible for ROS production like NADPH oxidase [Nature Reviews Drug Discovery, 2014].
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