alcohol glutathione-dependent formaldehyde dehydrogenase Your Prodrug Releases Formaldehyde: Should You Be Concerned? No! Amino acid dependent formaldehyde metabolism

This suggests that the pathological processes and tissue damage established over years of CFTR dysfunction may not be entirely reversible by the current levels of CFTR correction achieved, or that the restoration of CFTR function is insufficient to fully extinguish these self-perpetuating cycles of inflammation and oxidative damage

10.1038/s41419-019-1364-0 Cell Death Dis

Cadmium [25], lead [68], and mercury [912] have no essential biochemical roles, but exert diverse, severe toxicities in multiple organ systems as they bind in tissues, create oxidative stress, affect endocrine function, block aquaporins, and interfere with functions of essential cations such as magnesium and zinc

Skin changes are visiblebut internal oxidative stress creeps in more quietly

2018;314(3):H65968