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The first step, catalyzed by glutamate-cysteine ligase (GCL), is rate-limiting and regulated by GSH (competitive inhibitor) and by cysteine availability ( GSH degradation is catalized by -glutamyltranspeptidase (GGT), an enzyme that catalyzes the cleavage of the peptide bond between cysteine and the -carboxyl group of glutamate, and the transfer of the -glutamyl moiety to water (hydrolysis), an amino acid, or a short peptide (transpeptidation) (Figure 1)

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Nearly one-third of patients report a family history of migraine