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[4] In the initiation phase, a pro-oxidant hydroxyl radical (OH) abstracts the hydrogen at the allylic position (CH 2 CH=CH 2 ) or methine bridge (=CH) on the stable lipid substrate, typically a polyunsaturated fatty acid (PUFA), to form the lipid radical (L) and water (H 2 O)

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For instance, a study found that 89% of endometrial serous carcinoma (ESC) cases exhibited positive NRF2 expression, whereas only 28% of endometrioid carcinoma cases showed similar levels (107)

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Moreover, because the MCTs carries both l-and d-lactate, the latter might act as a competitive inhibitor of l-lactate transport, and so reducing neuroprotection mediated by the uptake of l-lactate already present in the medium