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These changes cannot occur without reducing the central cobalt ion from the + 3 oxidation state to + 2 or + 1 because cobalamins with a Co + 3 central ion are stable six-coordinate systems
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Lancet, 403 (10446), 28202836
Mitochondrial dysfunction leading to oxidative stress also induces FGF21 expression in preclinical disease models ( Enhanced secretory load, imbalances in redox homeostasis, or perturbations in protein homeostasis triggered by lysosomal or autophagosomal dysfunction may all cause ER stress and trigger the unfolded protein response (UPR)
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