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These include increased expression of glutamate cysteine ligase (also referred to as -glutamylcysteine synthetase) to promote GSH synthesis (272), upregulation of glutaredoxins that catalyze the reduction of S-glutathionylated proteins in the mitochondrial membrane (22), and increased expression and activation of the transcription factor, nuclear factor (erythroid-derived 2)-like 2 (Nrf2), which regulates the expression of several genes essential for GSH synthesis and homeostasis (188)

Glycaemic control and macrovascular and microvascular outcomes: A systematic review and meta-analysis of trials investigating intensive glucose-lowering strategies in people with type 2 diabetes

However, Zepbound has the advantage of being currently available by prescription, while Retatrutide is still in later stages of clinical development