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Health position paper and redox perspectives – Bench to bedside transition for pharmacological regulation of NRF2 in noncommunicable diseases
Open accessAbstract
Nuclear factor erythroid 2-related factor 2 (NRF2) is a redox-activated transcription factor regulating cellular defense against oxidative stress, thereby playing a pivotal role in maintaining cellular homeostasis. Its dysregulation is implicated in the progression of a wide array of human diseases, making NRF2 a compelling target for therapeutic interventions. However, challenges persist in drug discovery and safe targeting of NRF2, as unresolved questions remain especially regarding its context-specific role in diseases and off-target effects. This comprehensive review discusses the dualistic role of NRF2 in disease pathophysiology, covering its protective and/or destructive roles in autoimmune, respiratory, cardiovascular, and metabolic diseases, as well as diseases of the digestive system and cancer. Additionally, we also review the development of drugs that either activate or inhibit NRF2, discuss main barriers in translating NRF2-based therapies from bench to bedside, and consider the ways to monitor NRF2 activation in vivo.
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“Compared to the systemic administration of Nrf2 agonists, the localized activation strategy provided by TA-GelMA circumvents potential side effects related to systemic Nrf2 activation58,59, thereby enhancing clinical application safety.”
From Intelligence-responsive wettability switch coating on magnesium implants for treating osteoporotic fracture (2026) · cites this paper as [59]
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Self-citation
Metadata
- Authors
- Cuadrado, A., Cazalla, E., Bach, A., Bathish, B., Naidu, S. D., DeNicola, G. M., Dinkova-Kostova, A. T., Fernández-Ginés, R., Grochot-Przeczek, A., Hayes, J. D., Kensler, T. W., León, R., Liby, K. T., López, M. G., Manda, G., Shivakumar, A. K., Hakomäki, H., Moerland, J. A., Motohashi, H., Rojo, A. I., Sykiotis, G. P., Taguchi, K., Valverde, Á. M., Yamamoto, M., & Levonen, A.-L.
- Affiliations
- Biomedical Research Networking Center on Neurodegenerative Diseases (ES)
- Consejo Superior de Investigaciones Científicas (ES)
- University of Copenhagen (DK)
- University of Dundee (GB)
- Moffitt Cancer Center (US)
- Fred Hutch Cancer Center (US)
- Indiana University School of Medicine (US)
- Hospital Universitario de La Princesa (ES)
- Institutul National Victor Babes (RO)
- University of Eastern Finland (FI)
- Tohoku University (JP)
- Corresponding author
- Cuadrado, Antonio
- ORCID
- Cuadrado, Antonio
- Cazalla, Eduardo
- Bach, Anders
- Bathish, Boushra
- Naidu, Sharadha Dayalan
- DeNicola, Gina M.
- Fernández-Ginés, Raquel
- Hayes, John D.
- Kensler, Thomas W.
- Liby, Karen T.
- López, Manuela G.
- Manda, Gina
- Hakomäki, Henriikka
- Moerland, Jessica A.
- Motohashi, Hozumi
- Rojo, Ana I.
- Sykiotis, Gerasimos P.
- Taguchi, Keiko
- Valverde, Ángela M.
- Yamamoto, Masayuki
- Levonen, Anna-Liisa
- Venue
- Redox Biology
- Publisher
- Elsevier BV
- Published
- 2025-04
- Volume
- 81
- Pages
- 103569
- ISSN
- 2213-2317 (ISSN-L)
- PMC
- PMC11970334
- OpenAlex
- W4408102298
- Cited by
- 28
- References
- 551
- Citations by year
- 2026: 19 · 2025: 9
- FWCI
- 8.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Redox Biology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion, cc-by-nc-nd)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc-nd)
- SERVAL (Université de Lausanne) (publishedVersion, cc-by-nc-nd)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- IRIS (submittedVersion, cc-by-nc-nd)
- Biblos-e Archivo (Universidad Autónoma de Madrid) (submittedVersion, public-domain)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc-nd)
- Funders
- Instituto de Salud Carlos III (CB06/05/0010)
- Biotechnology and Biological Sciences Research Council (BB/X00029X/1, BB/T508111/1)
- Lundbeck Foundation (R366-2021-270)
- Comunidad de Madrid (P2022/BMD-7230, P2022/BMD-7230-CAM-22)
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas
- Syöpäsäätiö
- Ministerio de Ciencia e Innovación
- Foundation for the National Institutes of Health
- Ministerio de Universidades (FPU21/02505, FPU2021)
- Biogen (415,416, S217879)
- National Institutes of Health (PID-2021-122766OB-1363 100, MICIU/AEI/10.13039/501100011033, F31 CA275239)
- National Cancer Center
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (IZCOZ0_205415, 310030_212558)
- Tenovus (T22-08)
- European Cooperation in Science and Technology (CA20121)
- Narodowe Centrum Nauki (2021/43/B/NZ4/02130)
- Medical Research Council (MR/W023806/1, MR/T014644/1)
- Sigrid Juséliuksen Säätiö
- Ministerio de Ciencia, Innovación y Universidades (PID-2021-122766OB-100, PID2021-123481OB-I00, PDC2021-121 421-I00, PDC2022-133 765-I00)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Genomics, phytochemicals, and oxidative stress
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Redox biology and oxidative stress
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › NF-κB Signaling Pathways
- Keywords
- Nrf2, redox signaling, oxidative stress, non-communicable diseases, Nrf2 activators, Nrf2 inhibitors, drug development, translational medicine, autoimmune disease, respiratory diseases, cardiovascular disease, metabolic disorders, gastrointestinal diseases, cancer, off-target effects
- MeSH terms
- Noncommunicable Diseases, Animals, Humans, Neoplasms, Oxidation-Reduction, Oxidative Stress, NF-E2-Related Factor 2
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