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Excessive ROS generation leads to cellular damage by inducing lipid peroxidation, protein oxidation, and DNA damage

This results in energetically inefficient anaerobic glycolysis and defective tricarboxylic acid cycle, with sustained urinary excretion of pyruvate, orotate, citrate, -ketoglutarate, nitrogen-rich compounds and amino acids

(pyruvate acid) (lactic acid)

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In this process, the molecules NADH and FADH 2 - derived from the TCA cycle or from the OXPHOS cycle of fatty acid metabolism - are oxidized and thereby function as electron donors in a series of redox reactions (also referred to as the electron transport chain) with oxygen as ultimate electron acceptor (Mehta et al., 2017