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Comprised of TXN, thioredoxin reductase (TrxR), and nicotinamide adenine dinucleotide phosphate (NADPH), this system facilitates the reduction of oxidative GSH to its active form in response to NADPH [78], thereby supporting the removal of cytotoxic GSH by GPX4 [79, 80]
Episodes may last for hours or several days and can become severe enough to cause dehydration, electrolyte imbalance, esophageal irritation, malnutrition, and repeated hospitalization
While the risk of kidney injury risk is rare, it is often linked to dehydration from digestive side effects of the drug such as nausea and vomiting