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131 , 132 Patients with Sjgren's syndrome and systemic lupus erythematosus, who exhibit specific autoantibodies, are found to have a higher occurrence of null alleles for one or more GST enzymes, notably GSTM1

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J Biol Chem 270(7):29062913

However, a suitable protocol is required in order to avoid production of insoluble and/or inactive PPO 40,41,42,43

In both occurrences, N-Acetyl-Cysteine (NAC) supplementation supplies the cysteine necessary for GSH synthesis and contemporarily reduces HHcy, improving the GPx1 activity and further reducing oxidative stress

in a single-center retrospective study, where higher lactate levels were observed in patients with connective tissue disease-associated PAH and right heart failure who died from PAH progression compared to survivors [217]