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Furthermore, increased strand breaks generation caused activation of poly(ADP-ribose) polymerase (PARP), a zinc finger DNA-binding protein, known to deplete intracellular NAD + reserves as well as energy stores, thus ultimately resulting in cell death (429)

PTECs are highly sensitive to hyperglycemia (14)

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Nonetheless, it is important to highlight the high heterogeneity and limitations of the studies, such as (1) low to moderate methodological quality, (2) variation in a selected population, (3) a lack of inclusion and evaluation in different skin types, (4) small sample sizes, (5) variable designs, (6) types of chemical peels, (7) deficient efficacy measures, (8) short-term or no follow-up, (9) attrition rate, (10) heterogeneities in the grouped results, and (11) poor conclusions

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Its levels decline after age 60, and lower levels are linked to faster cognitive decline, while higher levels are associated with reduced risks of heart disease and overall mortality, suggesting its importance for healthy aging and disease prevention