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Excessive iron promotes the Fenton reaction, generating more ROS, further damaging melanocytes, while glutathione peroxidase 4 (GPX4), a key regulatory factor in ferroptosis, shows significantly downregulated expression in vitiligo

On the other hand, NAC serves as a precursor to glutathione

At the periphery, the production of neopterin and nitric oxide during inflammation consumes tetrahydrobiopterin to the detriment of the hydroxylase enzymes that use this compound as a cofactor.[ref] Genetic variants can also significantly influence BH4 levels when the body is under stress

PMID 8185623

LV is funded by a Sir Henry Dale Fellowship awarded jointly by the Wellcome Trust and the Royal Society (#221805/Z/20/Z), and also acknowledges the support of the Slovak Grant Agencies VEGA (#2/0004/23) and APVV (#21-0299)

In addition to increasing Camkk2 mRNA expression, valproate has been reported to acutely activate AMPK, which suggests that valproate may also increase CaMKK2 activity [182]