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thus, decreased levels can make them more susceptible to damage from oxidative stress, leading to rupture and causing hyperbilirubinemia and anemia ( GSSD can be diagnosed based on clinical presentation, an elevated urinary 5-oxoprolinuria concentration, and low GSS activity in erythrocytes or fibroblasts

In addition, the increased expression and activity of NOX and xanthine oxidase and NOS becoming uncoupled and structurally unstable also lead to increased ROS production [8]

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References Minich DM, Brown BI