Taccone-Gallucci M, Lubrano R, Clerico A, Meloni C, Morosetti M, Meschini L, Elli M, Trapasso E, Castello M A, Casciani C U
Clinica Chirurgica, II Università di Roma, Italy.
ASAIO J. 1992 Oct-Dec;38(4):855-7.
In patients on hemodialysis, a metabolic block of the pentose phosphate shunt has been described that impairs the reduction of oxidized glutathione. The block results in lack of detoxication of the free hydroxyl radicals produced inside the red blood cell (RBC) and causes oxidative damage to the polyunsaturated fatty acids of the RBC membrane that results in formation of aldehydes. Malonyldialdehyde has been used as an index of the oxidative damage. In a study group of 13 patients on hemodialysis, the authors have tested whether administering reduced glutathione (GSH) at 1200 mg/day for 1 month could minimize oxidative damage to the RBC membranes and improve the hematologic parameters. Treatment with GSH was followed by significant improvement of hematocrit (P = 0.008), hemoglobin (P = 0.03), and RBC count (P = 0.0037); however, oxidative damage to the membranes was increased (P = 0.0004), which suggests that improvement of the hematologic parameters is not related to reduction of the oxidative damage. This is because oxidized glutathione, formed in the oxidative process, cannot be reduced back to GSH because of alteration of the pentose phosphate shunt.
在接受血液透析的患者中，已发现磷酸戊糖途径存在代谢阻滞，这会损害氧化型谷胱甘肽的还原。这种阻滞导致红细胞（RBC）内产生的游离羟基自由基无法解毒，并对RBC膜的多不饱和脂肪酸造成氧化损伤，进而导致醛类物质的形成。丙二醛已被用作氧化损伤的指标。在一个由13名接受血液透析的患者组成的研究组中，作者测试了每天给予1200毫克还原型谷胱甘肽（GSH），持续1个月，是否能将对RBC膜的氧化损伤降至最低并改善血液学参数。GSH治疗后，血细胞比容（P = 0.008）、血红蛋白（P = 0.03）和RBC计数（P = 0.0037）有显著改善；然而，膜的氧化损伤却增加了（P = 0.0004），这表明血液学参数的改善与氧化损伤的减轻无关。这是因为在氧化过程中形成的氧化型谷胱甘肽由于磷酸戊糖途径的改变而无法还原回GSH。
