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In addition, Shaghayegh Haghjooy Javanmard et al

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210 This effect may be mediated by retrograde signaling from the mitochondria to the nucleus, which regulates ATP levels via the ANT2/AMPK/PGC-1 (peroxisome proliferator-activated receptor- coactivator-1) signaling pathway in cases of SIRT4 deficiency

Given the narrative nature of this review, a double-blind screening process was not applied, which is acknowledged as a limitation