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Once inside the cell, cystine is reduced to L-cysteine, which is then used by glutamate-cysteine ligase (GCL) and glutathione synthetase (GSS) to synthesize GSH, with NADPH serving as a key reducing cofactor

A detailed understanding of the MetS mechanism will help develop effective prevention strategies and appropriate intervention tools

Methylmalonic acid is especially helpful when standard B12 levels appear falsely elevated but symptoms remain

These unresolved issues not only constrain its translational potential as a therapeutic target but also challenge our understanding of the nature of neurodegenerative diseases