The reaction, or collision really, of nitric oxide with superoxide forms the much more powerful oxidant peroxynitrite. This is triggered by chemical changes in our body caused by a combination of all the factors discussed here. Aside from the environmental and dietary ones, a significant detail is the fact that peroxynitrite has the potential to release copper from ceruloplasmin which causes a decrease in the ferroxidase activity of ceruloplasmin and oxidation of LDL cholesterol, or lipid peroxidation. The reduced activity of ceruloplasmin, the enzyme that governs iron metabolism, has great consequences and is particularly relevant for neurodegenerative processes and metabolism.
Peroxynitrite contributes to chronic inflammation, cellular stress, autonomic dysfunction, endothelial and epithelial dysfunction and most importantly, from a deutenomic perspective (deuterperspective), peroxynitrite causes mitochondrial dysfunction which affects the efficiency in the ability to protect mitochondria from deuterium.