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Betaine aldehyde is then oxidized to betaine by aldehyde dehydrogenase 7 family member A1 (encoded by the ALDH7A1 gene) which is also known as betaine aldehyde dehydrogenase and as antiquitin (ATQ1)

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More specifically, NRF2 and KEAP1 have been analyzed in postmortem motor cortex and spinal cord specimens from ALS patients and a reduction in both NFE2L2 mRNA and NRF2 protein has been found in ALS patient tissues when compared to control ones