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Several studies reported that SP displayed protective effects in rats liver and kidney against toxicities through upregulation of the SIRT1 expression 28,29

Finally, dihydrolipoamide dehydrogenase activity in the glycine cleavage system (L protein) and in the -ketoacid dehydrogenase complexes (protein E3) catalyzes the conversion of the dihydrolipoyl moiety (reduced form) to the lipoyl moiety (oxidized form)

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Contrary to this notion, a large cohort of more than 74,000 patients treated with spironolactone found no evidence of an increased risk of breast, ovarian, or endometrial cancer.[50] These results have been supported by several other recent studies that investigated the potential relationship between spironolactone and risk of hormonally dependent cancers.[51,52] All in all, spironolactone is a safe systemic medication to consider for healthy women seeking treatment for oily skin

Finally, theres a need for larger-scale, well-designed, randomized controlled trials to answer these shortcomings and inconsistencies of existing studies