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Oxidative stress decreases BH4 levels in the endothelium, driving the uncoupling of nitric oxide synthase and the production of more oxidative stress

For tablet applications, consider using acetylated glutathione as an alternative, which offers compression stability though slightly lower bioavailability than liposomes

To bridge the preclinicalclinical gap, three concrete translational pathways are proposed: (1) Biomarker validation: Conduct prospective human cohort studies to verify preclinical biomarkers (e.g., GSDMD-NT for pyroptosis, HMGB1 for inflammation, MDA for lipid peroxidation, ferritin for ferroptosis) in serum and liver biopsies of EHS/CHS patients, establishing their diagnostic (early liver injury detection) and prognostic (MODS progression prediction) utility [59, 89]