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Retinal ischemia-hypoxia induced by BRB impairment further triggers neovascularization and nonperfusion, which exacerbates oxidative stress dysregulation and iron metabolism imbalance, forming a vicious positive feedback loop between oxidative stress and BRB damage that accelerates DR pathogenesis and amplifies ferroptosis susceptibility via iron overload and lipid peroxidation

Indeed, cambialism may not simply be a feature that has evolved multiple independent times, but may also be under positive selection in nature to allow a bacterial pathogen to circumvent host-derived nutritional immunity during an infection

A 2005 study by Finkley et al

Glucogenic substrate levels in fasting man