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Ketone bodies are released by the liver via solute carrier 16A (SLC16A) family members 1, 6, and 7 and circulate to extrahepatic tissues where they primarily undergo terminal oxidation (Halestrap, When ketone bodies are delivered to the peripheral organs, -OHB is oxidized back to AcAc by the mitochondrial D--hydroxybutyrate dehydrogenase (Figure 2)

This process involves the activation of a cascade of caspase enzymes, particularly caspase-3, which executing apoptosis through the cleavage of key intracellular substrates

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