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Elevated aspartate aminotranferase (AST) is the most sensitive marker of acetaminophen toxicity

This sustained elevation is what inhibits melanogenesis: glutathione competitively inhibits tyrosinase (the rate-limiting enzyme in melanin synthesis) and shifts melanin production from eumelanin (brown-black pigment) toward pheomelanin (red-yellow pigment), resulting in visible skin lightening over 612 weeks of biweekly administration

This imbalance significantly disrupts the basal ganglia circuitry, leading to the hallmark motor symptoms of PD, including tremors, bradykinesia, and rigidity

Wong BC, Jiang X, Fan XM, et al