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Altered gene expression of the astrocytic lactate efflux transporter (monocarboxylate transporter 4, SLC16A4) together with reduced lactate levels found in the spinal cord of hSOD1 G93A mice further suggest that metabolic interaction between neurons and astrocytes may be disrupted in ALS (Ferraiuolo et al., 2011)

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By inhibiting this interaction, FOXO4-DRI allows reactivation of the apoptotic pathway in non-proliferative senescent cells, leading to their selective elimination without damaging healthy tissue