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Lifestyle factors such as maternal smoking, alcohol consumption, and recreational drug use stimulate production of unfavorable amounts of ROS leading to OS, which renders physiological processes of female reproduction and the fetus vulnerable to oxidant-induced damage

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The classification also does not take into account heterozygosity, which results in a wider spread of residual enzyme activity, as well as the effect of compounding mutations which has been shown to synergistically decrease the catalytic activity and/or protein stability (34)

7.11.12 Alpha lipoic acid (ALA), a potent antioxidant having both hydrophilic and hydrophobic properties and serving as a cofactor for several mitochondrial enzymes, represents one potential intervention for improving DPN

N Engl J Med 323 : 16 Taaffe DR et al