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Blood work including inflammatory markers (CRP, ESR), cytokine panels, and immune cell subsets can provide deeper insight into whether the protocol is modulating the underlying immune dysfunction

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Among them, the glutamate produced by the decomposition of glutamine via GLS not only provides the raw material for the synthesis of GSH but is also further metabolized into -ketoglutarate (-KG) in the mitochondria under the action of glutamate dehydrogenase (GLUD1) or transaminases and then enters the tricarboxylic acid cycle to produce ATP [29]

doi: 10.1378/chest.11-0180 110 JayaramLVandalACChangCLLewisCTongCTufferyCet al