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A redox-active cofactor for several biosynthetic enzymes, also functioning as an RTA by reacting with peroxyl radicals, yielding oxidation products such as dihydrobiopterin (BH 2 ), which can be reduced back to BH 4 by the enzyme dihydrofolate reductase

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Its actions, however, are highly context-dependent, and under conditions of NAD + depletion, specific cell types, dosing imbalances, or advanced disease, SIRT1 may exacerbate oxidative damage by impairing repair enzyme activity, exacerbating mitochondrial dysfunction, and weakening antioxidant responses

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