氧化还原失衡是指氧化和还原途径的破坏，在癌症的发生、发展和治疗中发挥着核心作用。尽管氧化还原失衡传统上以高水平的氧化应激为特征，但新的证据表明，过度还原的环境同样不利于癌症增殖。与氧化 NAD 相比，还原应激的定义是抗氧化剂水平升高，包括谷胱甘肽和 NADH 升高，氧化 NAD 会破坏增殖所需的中心生化途径。随着测量和操纵还原应激的新技术的出现，这种被忽视的代谢应激的传感器和驱动因素开始被揭示。在某些基因定义的癌症中，针对还原应激途径可能是一种有效的策略。基于氧化还原的途径逐渐被认为是重要的“调节中心”，对还原应激信号传导的更广泛理解不仅有望揭示对代谢稳态的新见解，而且有可能改变癌症的治疗选择。版权所有 © 2023。由 Elsevier Inc 出版。

Redox imbalance is defined by disruption in oxidative and reductive pathways and has a central role in cancer initiation, development, and treatment. Although redox imbalance has traditionally been characterized by high levels of oxidative stress, emerging evidence suggests that an overly reductive environment is just as detrimental to cancer proliferation. Reductive stress is defined by heightened levels of antioxidants, including glutathione and elevated NADH, compared with oxidized NAD, which disrupts central biochemical pathways required for proliferation. With the advent of new technologies that measure and manipulate reductive stress, the sensors and drivers of this overlooked metabolic stress are beginning to be revealed. In certain genetically defined cancers, targeting reductive stress pathways may be an effective strategy. Redox-based pathways are gaining recognition as essential 'regulatory hubs,' and a broader understanding of reductive stress signaling promises not only to reveal new insights into metabolic homeostasis but also potentially to transform therapeutic options in cancer.Copyright © 2023. Published by Elsevier Inc.