SIRT5 expression is directly correlated with favorable prognosis, as its loss promotes glutamic-oxaloacetic transaminase 1 acetylation, thus promoting cell proliferation by enhancing glutamine and glutathione metabolism.455 Upregulation of SIRT6 by tumor suppressor KLF10 activity influences glycolysis, EMT, and distant metastasis of PC.456 SIRTs are associated with drug resistance of PC. The gene discussed is SIRT5; the disease is pachyonychia congenita.