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Malate dehydrogenase subsists as three isozymes: one mitochondrial, a cytosolic form, and a peroxisomal form

However, the GSH to oxidized GSSG ratio can decrease with lead exposure, indicating increasing oxidative stress and glutathione depletion

It seems reasonable to conclude that a generally impaired antioxidant system is an obvious contributory factor that may contribute to these clinical findings, however, the precise importance of GSH deficiency presents a more complex scenario

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