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Despite this promise, several critical limitations remain: No large-scale, randomized controlled human trials to confirm efficacy, safety, or long-term impact Toxicology and pharmacokinetic data are lacking, especially for chronic use or high-dose regimens Only one stereoisomer (all-L form) has been tested

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J Phys Chem A 118:60786084 Wang J, Yang H, Li W, Xu H, Yang X, Gan L (2015) Thioredoxin 1 upregulates FOXO1 transcriptional activity in drug resistance in ovarian cancer cells