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Arsenic has been shown to interfere with glucocorticoid and thyroid hormone signaling, while lead exposure has been associated with altered reproductive hormone levels and impaired feedback mechanisms in the hypothalamicpituitarygonadal axis [85]

Over decades, GSTP, GSTA, GSTM, and GSTO inhibitors have been identified, and some of them have already been applied for clinical investigation or therapeutics

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Therefore, the debate over the therapeutic potential of NAC in subgroups of IPF patients is evident, and it is hoped that the studies in carriers of the TOLLIP rs3750920 genotype will confirm the reported benefits of NAC in this subgroup before the potential of NAC in IPF is excluded [42]