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Lipid metabolism reprogramming can be observed even outside histological tumour boundaries [71], and lipidomic analysis of serum holds promise for detecting PDAC [72]

4.4 Oxidative stress and endothelial cells Vascular endothelial cells not only function as a selective barrier but also synthesize and secrete diverse active molecules, participate in inflammatory processes, and regulate vascular elasticity

In this phase, studies have suggested that macrophages secrete proteases, especially matrix metalloproteinase-9 (MMP-9), to destroy elastin, fibrin, and other matrix proteins that the tension of the fibrous cap comes from, making macrophages an important player in plaque destabilization (97)

The thioredoxin antioxidant system

Mitochondrial glutathione transferases involving a new function for membrane permeability transition pore regulation