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Figure 3: Acetaldehyde, a byproduct of alcohol, disrupts the balance of SAM and SAH, increasing homocysteine (Hcy) conversion to methionine while reducing cysteine and glutathione (GSH) production

Decreased levels of carnosine seen in our study in both ME/CFS and long COVID may contribute to patients experience of muscle fatigue, which has been previously associated with acidosis [79]

CHAC1 emerges as a key stress-responsive effector, transcriptionally upregulated via the ATF4-CHOP axis during endoplasmic reticulum stress and amino acid deprivation

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