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Primary pathological features include hepatic fat accumulation, inflammation, fibrosis, and ballooning degeneration of hepatocytes

The last GSH synthetic process is the one depending on the conversion of the oxidized dimer GSSG to 2 reduced GSH molecules in cells by glutathione reductase (GR), an ubiquitous enzyme of the family of disulfide reductases, in the presence of NADPH and flavin adenine dinucleotide -FAD-