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Under pathological conditions, the following three main mechanisms (oxidative stress, ER stress, and mitochondrial dysfunction) can affect drug metabolism of the liver, and drug metabolites further aggravate liver injury

In radioresistant GSCs, IR enhances H3K27ac enrichment at the CD47 promoter through HDAC7-dependent mechanisms, leading to increased CD47 expression and suppression of macrophage-mediated phagocytosis, thereby promoting immune evasion after radiotherapy (Sun et al., 2024b)

It has been proposed that reactive oxygen species (ROS) produced by the breakdown of vital mitochondrial enzymes, along with those released during RNA processing, gene transcription, and inflammatory processes, causes liver and kidneys to suffer from oxidative stress and cellular damage (5)