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It has been discovered that Astragaloside-IV, a naturally occurring substance from Astragalus, downregulates miR-138-5p in retinal pigment epithelial (RPE) cells of the DR model, leading to a boost in the expression of Nrf2, Sirtuin 1 (Sirt1), the antioxidant activity of GPX4, glutamatecysteine ligase modifier subunit (GCLM) and glutamatecysteine ligase catalytic subunit (GCLC), suggesting that the miR-138-5p/Sirt1/GPX4 axis helps mitigating ferroptosis and promotes cell survival in RPE cells exposed to high glucose conditions [116]

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Role of nrf2 in oxidative stress and toxicity