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Generally, biologic activity of ATRA such as gene expression or inhibition through direct DNA interaction is being exerted by binding to nuclear retinoid receptors (ligand-activated transcription factors) like (all- trans ) retinoic acid receptors (RARs) or retinoid X receptors (RXRs) which together build a heterodimer [83, 96,97,98,99]

The hydrogen-carbon bonds on these methylene units have very low bond-dissociation energy, making the hydrogen atom to be abstracted easily in the radical reactions ( a -tocopherol is the most suitable antioxidant and protect the membrane from oxidation by reacting with the various lipid radicals generated in the peroxidation chain reaction of lipid

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Additionally, they also confirmed the safety of this strategy with respect to brain damage or thrombosis

SAH = S-adenosylHcy