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Faculty of Nutrition, Texas A&M University, College Station, TX, 77843;
* Department of Biochemistry and Molecular Biology, Beijing Institute of Radiation Medicine, Beijing, China 100850; and
Department of Animal Nutrition, China Agricultural University, Beijing, China 100094
2To whom correspondence should be addressed. E-mail: g-wu{at}tamu.edu.
| ABSTRACT |
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-glutamyl-cysteinyl-glycine; GSH) is the most abundant low-molecular-weight thiol, and GSH/glutathione disulfide is the major redox couple in animal cells. The synthesis of GSH from glutamate, cysteine, and glycine is catalyzed sequentially by two cytosolic enzymes,
-glutamylcysteine synthetase and GSH synthetase. Compelling evidence shows that GSH synthesis is regulated primarily by
-glutamylcysteine synthetase activity, cysteine availability, and GSH feedback inhibition. Animal and human studies demonstrate that adequate protein nutrition is crucial for the maintenance of GSH homeostasis. In addition, enteral or parenteral cystine, methionine, N-acetyl-cysteine, and L-2-oxothiazolidine-4-carboxylate are effective precursors of cysteine for tissue GSH synthesis. Glutathione plays important roles in antioxidant defense, nutrient metabolism, and regulation of cellular events (including gene expression, DNA and protein synthesis, cell proliferation and apoptosis, signal transduction, cytokine production and immune response, and protein glutathionylation). Glutathione deficiency contributes to oxidative stress, which plays a key role in aging and the pathogenesis of many diseases (including kwashiorkor, seizure, Alzheimers disease, Parkinsons disease, liver disease, cystic fibrosis, sickle cell anemia, HIV, AIDS, cancer, heart attack, stroke, and diabetes). New knowledge of the nutritional regulation of GSH metabolism is critical for the development of effective strategies to improve health and to treat these diseases.
KEY WORDS: amino acids oxidative stress cysteine disease
The work with glutathione (
-glutamyl-cysteinyl-glycine; GSH)3 has greatly advanced biochemical and nutritional sciences over the past 125 y (1,2). Specifically, these studies have led to the free radical theory of human diseases and to the advancement of nutritional therapies to improve GSH status under various pathological conditions (2,3). Remarkably, the past decade witnessed the discovery of novel roles for GSH in signal transduction, gene expression, apoptosis, protein glutathionylation, and nitric oxide (NO) metabolism (2,4). Most recently, studies of in vivo GSH turnover in humans were initiated to provide much-needed information about quantitative aspects of GSH synthesis and catabolism in the whole body and specific cell types (e.g., erythrocytes) (3,57). This article reviews the recent developments in GSH metabolism and its implications for health and disease.
| Abundance of GSH in Cells and Plasma. |
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| GSH Synthesis. |
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-glutamylcysteine synthetase (GCS) and GSH synthetase (Fig. 1). This pathway occurs in virtually all cell types, with the liver being the major producer and exporter of GSH. In the GCS reaction, the
-carboxyl group of glutamate reacts with the amino group of cysteine to form a peptidic
-linkage, which protects GSH from hydrolysis by intracellular peptidases. Although
-glutamyl-cysteine can be a substrate for
-glutamylcyclotransferase, GSH synthesis is favored in animal cells because of the much higher affinity and activity of GSH synthetase (9).
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-glutamyl substrate (10). The Km values of mammalian GSH synthetase for ATP and glycine are
0.04 and 0.9 mmol/L, respectively, which are lower than intracellular concentrations of ATP (24 mmol/L) and glycine (1.52 mmol/L) in rat liver. Both subunits of rat GCS and GSH synthetase have been cloned and sequenced (9), which facilitates the study of molecular regulation of GSH synthesis.
-Glutamylcysteine synthetase is the rate-controlling enzyme in de novo synthesis of GSH (8). Knowledge regarding in vivo GSH synthesis is limited, due in part to the complex compartmentalization of substrates and their metabolism at both the organ and subcellular levels. For example, the source of glutamate for GCS differs between the small intestine and kidney (e.g., diet vs. arterial blood). In addition, liver GSH synthesis occurs predominantly in perivenous hepatocytes and, to a lesser extent, in periportal cells (11). Thus, changes in plasma GSH levels may not necessarily reflect changes in GSH synthesis in specific cell types. However, recent studies involving stable isotopes (57) have expanded our understanding of GSH metabolism. In healthy adult humans, the endogenous disappearance rate (utilization rate) of GSH is 25 µmol/(kg · h) (6), which accounts for 65% of whole body cysteine flux [38.3 µmol/(kg · h)]. This finding supports the view that GSH acts as a major transport form of cysteine in the body. On the basis of dietary cysteine intake [9 µmol/(kg · h)] in healthy adult humans (6), it is estimated that most of the cysteine used for endogenous GSH synthesis is derived from intracellular protein degradation and/or endogenous synthesis. Interestingly, among extrahepatic cells, the erythrocyte has a relatively high turnover rate for GSH. For example, the whole-blood fractional synthesis rate of GSH in healthy adult subjects is 65%/d (6), which means that all the GSH is completely replaced in 1.5 d; this value is equivalent to 3 µmol/(kg · h). Thus, whole blood (mainly erythrocytes) may contribute up to 10% of whole-body GSH synthesis in humans (5,6).
| Regulation of GSH Synthesis by GCS. |
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B mediates the upregulation of GCS expression in response to oxidant stress, inflammatory cytokines, and buthionine sulfoximine-induced GSH depletion (2,8). S-nitrosation of GCS protein by NO donors (e.g., S-nitroso-L-cysteine and S-nitroso-L-cysteinylglycine) reduces enzyme activity (8), suggesting a link between NO (a metabolite of L-arginine) and GSH metabolism. Indeed, an increase in NO production by inducible NO synthase causes GCS inhibition and GSH depletion in cytokine-activated macrophages and neurons (12). In this regard, glucosamine, taurine, n-3 PUFAs, phytoestrogens, polyphenols, carotenoids, and zinc, which inhibit the expression of inducible NO synthase and NO production (13), may prevent or attenuate GSH depletion in cells. Conversely, high-fat diet, saturated long-chain fatty acids, low-density lipoproteins, linoleic acid, and iron, which enhance the expression of inducible NO synthase and NO production (13), may exacerbate the loss of GSH from cells. | Regulation of GSH Synthesis by Amino Acids. |
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Cysteine is readily oxidized to cystine in oxygenated extracellular solutions. Thus, the plasma concentration of cysteine is low (1025 µmol/L), compared with that of cystine (50150 µmol/L). Cysteine and cystine are transported by distinct membrane carriers, and cells typically transport one more efficiently than the other (8). It is interesting that some cell types (e.g., hepatocytes) have little or no capacity for direct transport of extracellular cystine. However, GSH that effluxes from the liver can reduce cystine to cysteine on the outer cell membrane, and the resulting cysteine is taken up by hepatocytes. Other cell types (e.g., endothelial cells) can take up cystine and reduce it intracellularly to cysteine (Fig. 1); cellular reducing conditions normally favor the presence of cysteine in animal cells.
Extracellular and intracellularly generated glutamate can be used for GSH synthesis (16). Because dietary glutamate is almost completely utilized by the small intestine (16), plasma glutamate is derived primarily from its de novo synthesis and protein degradation. Phosphate-dependent glutaminase, glutamate dehydrogenase, pyrroline-5-carboxylate dehydrogenase, BCAA transaminase, and glutamine:fructose-6-phosphate transaminase may catalyze glutamate formation (Fig. 1), but the relative importance of these enzymes likely varies among cells and tissues. Interestingly, rat erythrocytes do not take up or release glutamate (17), and glutamine and/or BCAAs may be the precursors of glutamate in these cells (Fig. 1). Indeed, glutamine is an effective precursor of the glutamate for GSH synthesis in many cell types, including enterocytes, neural cells, liver cells, and lymphocytes (18). Thus, glutamine supplementation to total parenteral nutrition maintains tissue GSH levels and improves survival after reperfusion injury, ischemia, acetaminophen toxicity, chemotherapy, inflammatory stress, and bone marrow transplantation (19).
Glutamate plays a regulatory role in GSH synthesis through two mechanisms: 1) the uptake of cystine, and 2) the prevention of GSH inhibition of GCS. Glutamate and cystine share the system Xc- amino acid transporter (8). When extracellular glutamate concentrations are high, as in patients with advanced cancer, HIV infection, and spinal cord or brain injury as well as in cell culture medium containing high levels of glutamate, cystine uptake is competitively inhibited by glutamate, resulting in reduced GSH synthesis (20). GSH is a nonallosteric feedback inhibitor of GCS, but the binding of GSH to the enzyme competes with glutamate (9). When intracellular glutamate concentrations are unusually high, as in canine erythrocytes, GSH synthesis is enhanced and its concentration is particularly high (9).
Glycine availability may be reduced in response to protein malnutrition, sepsis, and inflammatory stimuli (21,22). When hepatic glycine oxidation is enhanced in response to high levels of glucagon or diabetes (23), this amino acid may become a limiting factor for GSH synthesis. In vivo studies show that glycine availability limits erythrocyte GSH synthesis in burned patients (7) and in children recovering from severe malnutrition (21). It is important to note that dietary glycine supplementation enhances the hepatic GSH concentration in protein-deficient rats challenged with TNF-
(22).
The evidence indicates that the dietary amino acid balance has an important effect on protein nutrition and therefore on GSH homeostasis (8). In particular, the adequate provision of sulfur-containing amino acids as well as glutamate (glutamine or BCAAs) and glycine (or serine) is critical for the maximization of GSH synthesis. Thus, in the erythrocytes of children with edematous protein-energy malnutrition and piglets with protein deficiency, GSH synthesis is impaired, leading to GSH deficiency (3). An increase in urinary excretion of 5-oxoproline, an intermediate of the
-glutamyl cycle (Fig. 1), is a useful indicator of reduced availability of cysteine and/or glycine for GSH synthesis in vivo (7,21)
| Interorgan GSH Transport. |
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-Glu-(Cys)2 owing to
-glutamyl transpeptidase activity on the outer plasma membrane (Fig. 1). The extreme concentration gradient across the plasma membrane makes the transport of extracellular GSH or GSSG into cells thermodynamically unfavorable. However,
-Glu-(Cys)2 is readily taken up by extrahepatic cells for GSH synthesis. The kidney, lung, and intestine are major consumers of the liver-derived GSH (8). The interorgan metabolism of GSH functions to transport cysteine in a nontoxic form between tissues, and also helps to maintain intracellular GSH concentrations and redox state (8). | Roles of GSH. |
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Second, GSH reacts with various electrophiles, physiological metabolites (e.g., estrogen, melanins, prostaglandins, and leukotrienes), and xenobiotics (e.g., bromobenzene and acetaminophen) to form mercapturates (24). These reactions are initiated by glutathione-S-transferase (a family of Phase II detoxification enzymes).
Third, GSH conjugates with NO to form an S-nitroso-glutathione adduct, which is cleaved by the thioredoxin system to release GSH and NO (24). Recent evidence suggests that the targeting of endogenous NO is mediated by intracellular GSH (26). In addition, both NO and GSH are necessary for the hepatic action of insulin-sensitizing agents (27), indicating their critical role in regulating lipid, glucose, and amino acid utilization.
Fourth, GSH serves as a substrate for formaldehyde dehydrogenase, which converts formaldehyde and GSH to S-formyl-glutathione (2). The removal of formaldehyde (a carcinogen) is of physiological importance, because it is produced from the metabolism of methionine, choline, methanol (alcohol dehydrogenase), sarcosine (sarcosine oxidase), and xenobiotics (via the cytochrome P450-dependent monooxygenase system of the endoplasmic reticulum).
Fifth, GSH is required for the conversion of prostaglandin H2 (a metabolite of arachidonic acid) into prostaglandins D2 and E2 by endoperoxide isomerase (8).
Sixth, GSH is involved in the glyoxalase system, which converts methylglyoxal to D-lactate, a pathway active in microorganisms. Finally, glutathionylation of proteins (e.g., thioredoxin, ubiquitin-conjugating enzyme, and cytochrome c oxidase) plays an important role in cell physiology (2).
Thus, GSH serves vital functions in animals (Table 1). Adequate GSH concentrations are necessary for the proliferation of cells, including lymphocytes and intestinal epithelial cells (28). Glutathione also plays an important role in spermatogenesis and sperm maturation (1). In addition, GSH is essential for the activation of T-lymphocytes and polymorphonuclear leukocytes as well as for cytokine production, and therefore for mounting successful immune responses when the host is immunologically challenged (2). Further, both in vitro and in vivo evidence show that GSH inhibits infection by the influenza virus (29). It is important to note that shifting the GSH/GSSG redox toward the oxidizing state activates several signaling pathways (including protein kinase B, protein phosphatases 1 and 2A, calcineurin, nuclear factor
B, c-Jun N-terminal kinase, apoptosis signal-regulated kinase 1, and mitogen-activated protein kinase), thereby reducing cell proliferation and increasing apoptosis (30). Thus, oxidative stress (a deleterious imbalance between the production and removal of reactive oxygen/nitrogen species) plays a key role in the pathogenesis of many diseases, including cancer, inflammation, kwashiorkor (predominantly protein deficiency), seizure, Alzheimers disease, Parkinsons disease, sickle cell anemia, liver disease, cystic fibrosis, HIV, AIDS, infection, heart attack, stroke, and diabetes (2,31).
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| Concluding Remarks and Perspectives. |
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| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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3 Abbreviations used: GCS,
-glutamylcysteine synthetase; GSH, glutathione; GSSG, glutathione disulfide. ![]()
Manuscript received 5 December 2003. Initial review completed 16 December 2003. Revision accepted 18 December 2003.
| LITERATURE CITED |
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V. H. Castellanos, M. D. Litchford, and W. W. Campbell Modular Protein Supplements and Their Application to Long-Term Care Nutr Clin Pract, October 1, 2006; 21(5): 485 - 504. [Abstract] [Full Text] [PDF] |
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