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The pathophysiology of SCI is characterized by an initial primary injury followed by secondary deterioration

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Convergent mechanismsoxidative stress, mitochondrial insufficiency, cellular senescence, immunosenescence with low-grade inflammation, and disrupted cholinergic/catecholaminergic signalingjointly depress tear volume and alter composition

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Clinical studies have shown that a combination of glycine and N-acetylcysteine reliably increases low glutathione levels and thus reduces oxidative stress