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Oxidative strand cleavage arising from abstraction of the C4’-hydrogen atom can generate the C4’-oxidized abasic site (C4AP). The C4AP lesion can generate an ICL by reaction with an adenine residue on the opposing strand. Elimination of the 3’-phosphoryl group from the C4AP lesion produces the unsaturated C4AP lesion that can react with adenine or cytosine residues on the opposing strand to generate a complex lesion consisting of an ICL adjacent to a DNA strand break.
