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HDAC9 mediates the deacetylation and ubiquitination of the transcription factor Sp1 through its histone deacetylase activity modification, leading to Sp1 degradation, which inhibits the transcriptional expression of GPx4, a key factor in resistance to ferroptosis, and ultimately drives neuronal ferroptosis in models of cerebral ischemia

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Most healthcare providers recommend weekly intravenous sessions initially, transitioning to monthly maintenance treatments once symptoms improve