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This is likely because the hydrogen bond between GSH and D180 in the L2 region is unstable (Table 3), causing fluctuations that affect the L1 region, resulting in significant movement in residues 40 to 49

The Lancet, 391(10132), 487-498

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Although this is consistent and mechanistically validated across different preclinical models, as reviewed in the Preclinical and clinical applications of NAD + -modulating interventions for mitochondrial homeostasis and health benefits section, the correspondence between NAD + changes and mitochondrial or metabolic alterations is more complex in human studies