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Macrophages and inflammatory cells are also responsible for the production of elastase, an enzyme that can cause degradation of the tunica albuginea's elastic fibers [20, 22]

Precision medicine approaches should enroll participants based on biological signatures rather than broad diagnostic categories, including glutathione status, lactate to pyruvate ratios, N acetyl aspartate, NRF2 related profiles, electron transport chain complex activity, and the presence of folate receptor alpha autoantibodies in cerebral folate deficiency

Emerging evidence suggests that AFDAS may represent a distinct clinical entity compared with previously diagnosed AF and may be associated with a lower risk of stroke recurrence (142, 143)

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