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The key pathological features of ALS include the loss of pyramidal Betz cells in the motor cortex, anterior horn cells in the spinal cord, and lower cranial motor neurons [179]

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Under these conditions, the increased demethylation levels of Cytosine-phosphate-Guanine islands in the NRF2 promoter region can lead to elevated expression of the NRF2 gene, thereby inhibiting the carcinogenic effects induced by Nano-SiO2 [154]

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Several studies, with and without controls, demonstrated a high prevalence of thyroid autoimmunity associated with alopecia areata 49 , whereas others found lower frequencies than in earlier studies, indicating that there is no need for detailed investigations into these diseases without a clinical history to suggest they are present 50