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Furthermore, dysfunction of sirtuins (e.g., SIRT5 and SIRT3) interferes with histone succinylation and acetylation, affecting mitochondrial enzyme activity and gene expression linked to renal tubular integrity [83]

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Rationale for Combination with Mesotherapy Given that mesotherapy addresses dermal matrix strength, antioxidant support and long-term pigment stabilisation, while picosecond lasers provide active pigment disruption, combining the two can yield synergistic benefits: Laser clears pigment and stimulates regeneration