Glutathione in Clinical Significance and Therapeutic Applications

Role in Disease States and Therapeutic Applications

In ferroptosis, a form of regulated cell death, glutathione peroxidase 4 (GPX4) plays a major role in inhibiting lipid peroxidation 1
N-acetylcysteine (NAC) serves as a cysteine donor and has been shown to inhibit eryptosis (programmed death of red blood cells) in vitro and prolong erythrocyte half-life in vivo 2
In clinical settings, glutamine supplementation (0.3-0.5 g/kg/day) is recommended for patients with burns >20% body surface area, as it serves as a precursor for glutathione synthesis 3, 4

Whole blood selenium measurement provides insight into glutathione peroxidase activity, as selenium is an essential component of these enzymes 5

In critically ill patients, glutamine serves as an important precursor for glutathione synthesis 6
Glutamine supplementation (0.2-0.3 g/kg/day) is recommended for critically ill trauma patients with complicated wound healing 3, 4
However, glutamine supplementation is not recommended for general ICU patients except those with burns or trauma 3, 4
Parenteral glutamine should not be administered in unstable ICU patients with liver and renal failure 6