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483 Modulating the gut microbiota through probiotics, prebiotics, and dietary interventions has shown the potential to improve autonomic function and reduce inflammation

Normally, the transcription factor Nrf2 and its inhibitory protein KEAP1 are tightly bound to inhibit activity, but in the presence of ROS, a conformational change in KEAP1 results in the release of NRF2, which binds to the antioxidant response element (ARE) and activates the downstream genes heme oxygenase-1 (HO-1), glutathione peroxidase 4 (GPX4), quinone oxidoreductase1(NQO1), thioredoxin reductase 1 (SRXN1), and transcription of solute carrier family 7 member 11 (SLC7A11), which enhance cellular antioxidant defenses and inhibit ferroptosis (Wang et al., 2022

Some patients feel improvement within weeks

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Iron and other metals in the pathogenesis of Parkinson's disease: toxic effects and possible detoxification