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The upregulation of Sirt3 and Sirt5 may have anti-apoptotic activities (Kincaid and Bossy-Wetzel, 2013), but decreased expression of Sirt1 disrupts the Sirt1-PGC-1 inter-relationships (Lavu et al., 2008)

This failure of vascular constriction leads to severe blood pooling in the lower extremities, a hallmark of POTS

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