When oxygen availability is limited, glucose is the most metabolically efficient fuel, and during myocardial ischemia, the ratio of acetyl-CoA/CoA in mitochondria increases, leading to the activation of pyruvate dehydrogenase (PDH) kinase, which in turn phosphorylates PDH to inhibit its activity
A similar phenomenon has been observed in experimental models succinate accumulation activates HIF-1, further enhancing glycolysis and pro-inflammatory factor release to accelerate alveolar destruction ( 4.2.2 Key cytokines and metabolic substrate abnormalities Matrix metalloproteinases (MMP-9, MMP-12) are secreted by macrophages and neutrophils to directly degrade elastic fibers of alveolar walls
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VDR plays a critical regulatory role in maintaining melanocyte homeostasis and photoprotection, particularly under ultraviolet B (UVB) exposure