Persistent ROS generation or electrophilic stress can oxidize GSH to GSSG more rapidly than it is reduced, thereby depleting the reduced thiol pool
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Its PPB is significantly lower than that of cisplatin, resulting in a lower risk of cumulative toxicity (Graham et al
Another study evaluating the effect of dLAN reports that as few as four days is sufficient to induce neuroinflammation in female mice (Walker et al., 2020) which can contribute toward neurotoxicity, increased neuronal damage within the penumbra, and delayed recovery post ischemia
However, these side effects have not been proven to be caused by the treatment, so they do not manifest in all people
A qualified provider can integrate pharmacokinetic understanding with individual health status to optimize both safety and efficacy during dose escalation