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Glutathione status in critically-ill patients: possibility of modulation by antioxidants

Published online by Cambridge University Press:  28 February 2007

Jan Wernerman ,
Jia-Li Luo  and
Folke Hammarqvist
Jan Wernerman*
Affiliation:
Department of Anaesthesia and Intensive Care and Unit of Anaesthesiologic Metabolism at KFC, Huddinge Hospital, Department of Surgery, St Görans Hospital, Karolinska Institutet, S-141 86 Huddinge, Stockholm, Sweden
Jia-Li Luo
Affiliation:
Department of Anaesthesia and Intensive Care and Unit of Anaesthesiologic Metabolism at KFC, Huddinge Hospital, Department of Surgery, St Görans Hospital, Karolinska Institutet, S-141 86 Huddinge, Stockholm, Sweden
Folke Hammarqvist
Affiliation:
Department of Anaesthesia and Intensive Care and Unit of Anaesthesiologic Metabolism at KFC, Huddinge Hospital, Department of Surgery, St Görans Hospital, Karolinska Institutet, S-141 86 Huddinge, Stockholm, Sweden
*
*Corresponding Author: Professor Jan Wernerman, fax +46 87795424, email Jan.Wernerman@anaesth.hs.sll.se
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Abstract

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Muscle tissue serves as a protein reservoir which is mobilized to meet the specific metabolic needs associated with various catabolic conditions in human subjects, such as trauma and critical illness. Glutathione is one of the most abundant short-chain peptides and a major source of non-protein thiol in the body, and tissue glutathione concentration is related to its oxidative capacity. Skeletal muscle is relatively unique with respect to a variety of metabolic properties, such as oxidative potential, patterns of amino acid utilization, and antioxidant enzyme activity. The glutathione concentration is not influenced by food intake, or by food deprivation. Moreover, there is no diurnal variation on muscle glutathione levels. Following elective surgery the muscle concentration of GSH (the reduced form) decreases by 40 % 24 h post-operatively, while the concentration of GSSG (the oxidized form) remains unaltered. During critical illness a similar decrease in the GSH concentration is seen, but in addition a change in the redox status indicative of an elevated GSSG level occurs. Furthermore, correlations between the concentrations of glutamine as well as glutamate and GSH exist in these patients. From available evidence accumulated it is clear that glutathione plays a pivotal role in the maintenance of the intracellular redox status, the antioxidant vitamin levels, and the antioxidant enzyme functions under various metabolic conditions. The effectiveness of glutathione protection in the individual tissue depends on the tissue concentration of glutathione as well as the capacity of the tissue to import GSH and to export GSSG. The mechanisms by which catabolism regulates tissue glutathione levels and the enzyme activities associated with the γ-glutamyl cycle are not completely understood and further studies need to be conducted.

Keywords

GlutathioneCritically illGlutamineSkeletal muscle
Type
Clinical Nutrition and Metabolism Group Symposium on ‘Nutrition and antioxidants’
Information
Proceedings of the Nutrition Society , Volume 58 , Issue 3 , August 1999 , pp. 677 - 680
Copyright
Copyright © The Nutrition Society 1999

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