Autoimmune diseases in G6PD deficient patients may be triggered by activation of TGF-β/NADPH oxidases/ROS signaling, the expression of ICAM-1 and VCAM-1, and the adhesion of leukocytes to the endothelial cells with endothelial to mesenchymal transition (31, 39). Here, ICAM1 is linked to autoimmune disease.