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This effect arises because of the nonlinear inhibition of GCL and GS by GSH [Figure 2B]
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This is especially relevant for endpoints such as viability, migration, and tube formation, which can be sensitive to culture conditions and reagent variability
Some countries allow medical use under supervision
Where results are borderline, measurement of methylmalonic acid (MMA) or holotranscobalamin (active B12) may help clarify the picture, as recommended in NICE CKS guidance on B12 and folate deficiency anaemia
