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The lack of efficacy of inhaled GSH in patients with cystic fibrosis could be explained by the high concentrations of the GSH-degrading enzyme -glutamyltransferase present in lung fluids of those patients (116123), and then, the use of precursors of GSH synthesis like NAC and cystine could be more effective in the synthesis of GSH (124)

Together, they push the same output (GH release) through two independent inputs

Fundam Clin Pharmacol

[16] One of the most important functions of glutamine is its ability to be converted into -KG, which helps to maintain the flow of the tricarboxylic acid cycle, generating ATP via the electron carriers NADH and FADH 2

Furthermore, studies of IGF-2 gene in transitional cell carcinoma of the bladder and MGMT gene in gastric cancer showed that patients with CT or TT MTHFR genotypes had reduced methylation of IGF-2 or MGMT compared those with CC genotype 36,37