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The ROS generated from aerobic respiration caused a cumulative oxidative damage in macromolecules, including lipids, DNA, and proteins, which subsequently lead to cells death (Scheibye-Knudsen et al., 2015), and affect the healthspan of numerous principal organ systems (Dai et al., 2014)

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Patients with pernicious anemia have an irreversible cause of deficiency, so its important to ensure other factors do not contribute to further deficiency progression

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