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~5% of APAP is metabolized via oxidation by the hepatic cytochrome P450 (mainly CYP2E1) into a toxic, highly reactive intermediate metabolite N-acetyl-p-benzoquinoneimine (NAPQI) *

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1 Like most complex genomic regulatory systems, Nrf2 (nuclear factor erythroid 2-related factor 2) is sequestered in the cytoplasm until it is able to translocate into the nucleus, where it forms a heterodimer with MAF (another transcription factor) and binds to the promoter region of genes containing an antioxidant response element (ARE) sequence

Some people see significant changes in the first month

This is reflected by the efficacy of topical probiotics in healthy subjects, with reductions in erythema, oedema and skin sensitivity observed [36]