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For some patients, this alone may be sufficient to provide both structural support and a regenerative stimulus

A redox-active cofactor for several biosynthetic enzymes, also functioning as an RTA by reacting with peroxyl radicals, yielding oxidation products such as dihydrobiopterin (BH 2 ), which can be reduced back to BH 4 by the enzyme dihydrofolate reductase

Its actions, however, are highly context-dependent, and under conditions of NAD + depletion, specific cell types, dosing imbalances, or advanced disease, SIRT1 may exacerbate oxidative damage by impairing repair enzyme activity, exacerbating mitochondrial dysfunction, and weakening antioxidant responses

Useful oxidative-damage markers may include urinary 8-OHdG , which reflects oxidative DNA damage, and lipid peroxides , which reflect oxidative damage to fats and cell membranes