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A previous study suggested that excessive oxidative stress-induced impaired autophagic flux is a key pathogenic event in DED (Wang et al., 2021)

As an example, variants in NT5C2 are not found at diagnosis, whereas specific variants in NT5C2 were observed in 7 of 44 (16%) and 9 of 20 (45%) cases of B-ALL with early relapse that were evaluated for this variant in two studies.[13,14] NT5C2 variants are uncommon in patients with late relapse, and they appear to induce resistance to mercaptopurine and thioguanine.[14] Another gene that is found altered only at relapse is PRSP1 , a gene involved in purine biosynthesis.[15] Variants were observed in 13.0% of a Chinese cohort and 2.7% of a German cohort, and were observed in patients with on-treatment relapses

J Endocrine Soc (2022) 6:bvab190

Curtis ARJ, Fey C, Morris CM, Bindoff LA, Ince PG, Chinnery PF, et al

(Fruits and vegetables provide only traces of L-carnitine.) the major sites of L-carnitine biosynthesis are the liver and kidney, as well as the brain and testes