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However, a landmark July 2025 study published in the Proceedings of the National Academy of Sciences (PNAS) by Shankar, Davis, Bonilla, et al., revealed a fascinating and complex paradox regarding redox homeostasis in these conditions

More reliable detection reagents would facilitate both the basic study of this axis as well as clinical development--advances in antibody and peptide generation (such as those employed by the Institute for Protein Innovation) will hopefully be leveraged to improve sensitivity and specificity of clinical assays

The -SH groups require re-oxidation to the disulfide (S-S) form to regenerate lipoate as a competent acetyl acceptor

At microdoses, the same mechanisms activate, just more gently