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Common symptoms of a haemolytic episode include: Sudden onset of fatigue and weakness often the earliest sign Pallor or yellowing of the skin and eyes (jaundice) caused by the release of bilirubin from broken-down red blood cells Dark or tea-coloured urine a hallmark sign indicating haemoglobin is being excreted through the kidneys Shortness of breath and rapid heart rate Abdominal or back pain Dizziness or light-headedness These symptoms can be mistaken for other conditions, including viral illness or a urinary tract infection particularly problematic given that some UTI treatments (such as nitrofurantoin) are themselves triggers
More precisely, among them, the cyclin-dependent kinase inhibitor p21 Cip1/WAF1 , induced by p53 in response to OS and involved in the regulation of cell cycle arrest, replication, cellular proliferation, and apoptosis, competes with KEAP1 for the binding to NRF2 through the DLG motif, thus preventing NRF2 ubiquitination, and increasing its stabilization [184, 185]
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