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Studies have demonstrated that enhancement of ROS and lipid peroxidation is one of the culprits in the elevation of -SMA and COL1A1, indicative of myofibroblast formation

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Other -glutamyl peptides, which include GSSG and a mixed disulfide of Cys and GSH (CySSG), can also bind this unique receptor and modulate its function [166]

This theory faces contradictions, such as HPA axis hypofunction being limited to certain patients, no early-stage changes in ME/CFS, and heightened immunosuppressive effects of glucocorticoids in these patients