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For women, the problem intensifies around perimenopause and menopause because estrogen also has antioxidant effects in mitochondria

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A study demonstrated that alterations in phosphatidylcholine (PC) metabolism in ARDS patients correlated with increased inflammation and oxidative stress, 50 resulting in more severe lung injury and lower levels of surfactant PC species, which contribute to alveolar collapse and heightened inflammation 51 (Figure 2)