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This patient's ambiguous genitalia and hyponatremia indicate an enzymatic block in steroidogenesis, meaning the adrenal glands cannot produce cortisol even if stimulated by ACTH

Morbidity and Mortality Weekly Report: Surveillance Summaries

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Activation of mitochondrial aldehyde dehydrogenase 2 (ALDH2) promoted 4-HNE detoxification, restored APN signaling and vascular regeneration, and ultimately improved diastolic function in diabetic hearts (Roy et al., 2022)