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Altered signal transduction pathways, mTOR is activated by relative depletion of glutathione and supplementation of N-acetyl cysteine (NAC), a precursor of glutathione

The distinct physical activity patterns observed in ME/CFS, characterized by reduced activity intensity but not increased sedentary behavior, further highlight the link between PEN and metabolic dysfunction, likely driven by issues with energy metabolism (Newton et al., 2011)

This issue remains to be sorted out

Then, elevated ROS could affect some important gene expression, such as heme oxygenase-1 (HO-1), hypoxia-inducible factor-1 (HIF-1), and NF-B, which also aggravate oxidative stress (Lavie, 2012)

Biochemistry 35 , 1576015771 (1996)