Glutathione

Overview

Glutathione is a tripeptide antioxidant synthesized intracellularly that maintains cellular redox balance, detoxifies xenobiotics, and regenerates vitamins C and E. As the most abundant non-protein thiol, it exists in reduced (GSH) and oxidized (GSSG) forms, with the GSH:GSSG ratio reflecting oxidative stress status. Low levels indicate oxidative stress, chronic inflammation, liver disease, or malnutrition, while direct clinical measurement has limited routine utility. Glutathione assessment is primarily research-focused for oxidative stress biomarkers rather than standard clinical diagnostics.

Clinical Use Cases

  • Research evaluation of oxidative stress in chronic diseases.
  • Assessment of liver detoxification capacity in toxicology.
  • Monitoring nutritional glutathione status in critical illness.
  • Limited clinical use; primarily investigational for neurodegenerative diseases.

Specimen Types

  • Whole blood (for erythrocyte glutathione).
  • Plasma (total glutathione).
  • Tissue biopsy (research).

Measurement Methods

  • High-performance liquid chromatography (HPLC) with fluorescence or electrochemical detection.
  • Enzymatic recycling assay (DTNB-GR method).
  • Mass spectrometry for GSH/GSSG ratio.

Test Preparation and Influencing Factors

  • Avoid acetaminophen and alcohol prior to testing.
  • Recent oxidative stress, inflammation, or critical illness depletes levels.
  • N-acetylcysteine supplementation elevates glutathione.
  • Sample processing critical: immediate acidification prevents GSH auto-oxidation.

Synonyms

  • GSH.
  • Reduced glutathione.
  • L-gamma-glutamyl-L-cysteinylglycine.

Further Reading