Reactive oxygen metabolites (ROMs) such as superoxide anion (

), hydrogen peroxide (H
2O
2), and nitric oxide (NO·), are generated at several intracellular sites and either are inactivated by antioxidative defenses or give rise to a constellation of secondary ROMs. Interactions with ROMs may cause oxidative modifications in macromolecules, some of which may be repaired. The age-related accumulation of unrepaired, irreversible oxidative damage may be a causal factor in aging and certain diseases. ROMs have also been linked to differentiation and signal transduction. An X indicates the interdiction by nonenzymatic antioxidant defense mechanisms (e.g., glutathione [GSH], vitamin E, vitamin C, and urate). SOD denotes superoxide dismutase.