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2 Ferroptosis and its link to DCM Ferroptosis is a form of programmed cell death driven by the excessive accumulation of iron ions within cells, triggering the Fenton reaction, activating oxidative stress, and disrupting lipid metabolism, ultimately leading to cellular demise ( Acyl-CoA synthetase long-chain family member 4 (ACSL4) is a key enzyme involved in the synthesis of polyunsaturated fatty acid phosphatidylethanolamine (PUFA-PE) ( In patients with DCM, the GSH-dependent antioxidant mechanism is suppressed, whereas ACSL4 activation promotes ferroptosis in myocardial cells ( In the development of DCM, sustained hyperglycemia acts as a key driver of ferroptosis

Accordingly, a recent study also found that BACH1 and BACH2 are the candidate key regulators in the phenotypic modulation of VSMC in healthy individuals and Marfan syndrome patients by analyzing of singlenucleus multiomic and spatial transcriptomic sequencing data

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Low Glutathione Levels in Patients Scientific studies have observed that individuals with chronic skin challenges often have significantly lower levels of glutathione in their blood and skin tissue compared to those without these concerns

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