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Mechanistically, indoxyl sulfate enhances platelet activities, increases response to collagen and thrombin, leading to thrombosis (Yang et al., 2017)

In addition, the glutaminase inhibitor IPN60090 can be combined with CB839 in the treatment of Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML), and with increasing doses of CB839 and IPN60090, the levels of intracellular NADPH and NADP+ are reduced, thereby inhibiting the proliferation of MDS and AML cells [72]

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Additionally, environmental factors such as iodine excess or deficiency, smoking, stress, exposure to chemicals, medications (e.g., amiodarone, interferon-), and some viral/bacterial infections can alter gene expression patterns through epigenetic mechanisms and trigger autoimmune processes