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Nrf2 is a key regulator, promoting HO-1 expression by activating the oxidative stress response ( BTB and CNC homology 1 (BACH1) suppresses HO-1 transcription under normal conditions, and stress signals lead to its degradation, allowing Nrf2 to initiate HO-1 expression ( activator protein 1 (AP-1) , heat shock factor 1 (HSF1) , nuclear factor kappa B (NF-κB) , and hypoxia-inducible factor 1 alpha (HIF-1α) contribute to the activation of HO-1 under various stress conditions ( In conclusion, the dual role of HO-1 is determined by a complex network of regulatory factors

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Gastrointestinal and Nerve Damage Another concern is the potential for adverse gastrointestinal symptoms and peripheral nerve damage