“…Another, and probably more important, mechanism to be considered is the modulation of transcription. Phytanic acid has been shown to bind and activate the nuclear receptors RXR [45][46][47] and PPAR-α [47], to enhance transcription of uncoupling protein-1 [48] and of fatty acid binding protein [49], and to induce adipocyte differentiation [48,50]. Other reported cellular effects of phytanic acid are nitric oxide-dependent apoptosis in vascular smooth muscle [51], morphological changes in retinal pigment epithelial cells, in particular generalized swelling, presence of lipid vacuoles and loss of apical microvilli, which are also seen in the retina of Refsum disease patients [52], and cytosolic calcium release, increase in reactive oxygen species and apoptosis due to mitochondrial impairment in rat hippocampal astrocytes [53,54].…”