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Reactive oxygen species (ROS)-related pathways encompass the complex biochemical networks responsible for the generation, signaling, and neutralization of oxygen-derived reactive molecules such as superoxide, hydrogen peroxide, and hydroxyl radicals (PMC, 2024). Under physiological conditions, these pathways act as critical secondary messengers in signal transduction, regulating processes like cell proliferation, differentiation, and the innate immune response (Antioxidants & Redox Signaling, 2015). However, an imbalance between ROS production and antioxidant defense mechanisms leads to oxidative stress, which causes oxidative damage to DNA, proteins, and lipids (Biocompare, 2024). This dysfunction is a hallmark of numerous pathologies, including cancer, cardiovascular diseases, and neurodegenerative disorders like Alzheimer's disease (MDPI, 2024). Therapeutic interventions targeting these pathways aim to restore redox homeostasis by either inhibiting ROS-generating enzymes such as NADPH oxidases (NOX), directly scavenging reactive species, or activating cytoprotective transcription factors like Nrf2 to boost endogenous antioxidant capacity (PMC, 2024; Frontiers, 2022). Despite the potential of these strategies, clinical success has been limited by the "antioxidant paradox," where non-specific scavenging interferes with essential physiological signaling (Antioxidants & Redox Signaling, 2015). Current research focuses on developing site-specific and isoform-selective modulators to minimize off-target effects and improve therapeutic outcomes (PMC, 2024).
Therapeutic agents modulate ROS-related pathways by directly scavenging reactive species, inhibiting enzymatic sources of ROS such as NADPH oxidase (NOX) and xanthine oxidase (XO), or activating the Nrf2-Keap1 signaling axis to induce the expression of endogenous antioxidant enzymes like superoxide dismutase and catalase (PMC, 2024; Antioxidants & Redox Signaling, 2015).
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