PTRH2 and prostate adenocarcinoma: At the molecular level, upregulation of PTRH2 in PRAD enhances the Bcl2-mediated suppression of mitochondrial outer membrane permeabilization, thereby reducing mitochondrial release of cytochrome c and ROS [63] This mechanism limits the release of damage-associated molecular patterns (DAMPs) linked to mitochondrial damage, such as mitochondrial DNA (mtDNA), which would otherwise activate the TLR9 receptor in macrophages, thereby promoting M1 polarization [64].