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In 2020 another open-label RCT of triple therapy with or without NAC, 1200 mg per day, was published, and reported that addition of NAC did not improve eradication rates

GSH, in such a high intracellular concentration, contributes to preventing these abnormal effects

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However, unlike GPX7, which is a transmembrane protein that contains a C-terminal KEDL endoplasmic reticulum localization sequence and a highly conserved N-terminal transmembrane domain (TMD) (Yoboue et al., 2017)

In addition, environmental triggers (such as viral infections) may induce epigenetic changes, disrupting immune tolerance mechanisms and initiating disease onset