4582-C THE PRESENCE OF FATTY LIVER IS ASSOCIATED WITH HIGHER TREATMENT RESPONSE IN PATIENTS WITH PRIMARY BILIARY CHOLANGITIS Leandro Sierra 1 , Romelia Barba Bernal 1 , Ana Marenco-Flores 1 , Bryan Ferrigno 2 , Daniela Goyes 3 , Wilfor Diaz Fernandez 2 , John Esli Medina Morales 4 , Alan Bonder 1 , Vilas Patwardhan 1 and ALD team, (1)Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, (2)Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, (3)Yale University Medical Center, New Haven, CT, United States, (4)Rutgers New Jersey Medical School, Kearny, NJ Background: Primary biliary cholangitis (PBC) is an autoimmune, chronic cholestatic liver disease involving bile ducts

The significant downregulation of essential energy metabolites such as AMP, ADP, and NADP indicates compromised energy metabolism, while the attenuation of antioxidant metabolites like glutathione suggests that the oxidative stress generated by these antibiotics may overwhelm bacterial antioxidant defense mechanisms
However, IV administration typically requires a healthcare provider's oversight
As people age, they start to produce less glutathione
Most studies focus on anecdotal accounts or small sample sizes, making it challenging to establish a causal relationship between coffee enemas and increased glutathione levels