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The main triggers are well established: UV exposure, inflammation, hormonal changes, pollution-related oxidative stress, and age-related decline in skin renewal

Indeed, isotope tracing in lung tumors has shown that exogenous lactate can label TCA metabolites extensively, contributing more carbon to the cycle than glucose in some cases 352
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10.1016/j.bcp.2008.04.016 111 YamaoriS.KinugasaY.JiangR.TakedaS.YamamotoI.WatanabeK

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