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Nevertheless, the convergence of (i) higher baseline CRP among improvers, (ii) the strong correlation with CRP/NLR and MELD, and (iii) the recognised role of glutathione in modulating redox-sensitive inflammatory pathways, does support a biologically coherent hypothesis: glutathione may be most useful in patients with an inflammatory phenotype, where oxidative stress and systemic inflammation are dominant, modifiable drivers of acute decompensation ( FIGURE 8 The apparent counter-intuitive finding that patients with higher baseline MELD, bilirubin, INR and CRP were more likely to improve also fits this picture

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