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Furthermore, peripheral estrogen hydroxylation was found to be increased in both men and women with SLE and estrogenic metabolites were reported to increase B cell differentiation and activate T cells [44]

Mechanistically, oxidative stress triggers endoplasmic reticulum stress through the activation of the PERK-eIF2-ATF4 and IRE1-XBP1 signaling pathways, as well as through the upregulation of CHOP (C/EBP homologous protein), which promotes apoptotic signaling (75) as shown in Figure 4

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10.1016/j.cmet.2023.11.017 162 WeiX.HuangQ.HuangJ.YuL.ChenJ