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NRF2-related epigenetic modifications in cardiac and vascular complications of diabetes mellitus

38 Downregulated signaling pathways AMPK signaling pathway AMPK is a pivotal serine/threonine protein kinase that plays an extensive role in the regulation of cellular energy metabolism 39

Original Study Citation Pamela RD

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These include inhaled adrenergics such as the beta-2 agonists (Ventolin), inhaled corticosteroids (Azmacort), and intranasal steroids used for allergic rhinitis (Flonase, Vancenase), or any other medication that attains poor or short lasting plasma levels

From an immunological perspective, these associations arise from a breakdown in self-tolerance mediated by overlapping T-cell and B-cell autoreactivity, shared cytokine pathways (e.g., IFN-, IL-18), and common antigen-presenting HLA alleles