Oxidative state of glutathione in red blood cells and plasma of diabetic patients: in vivo and in vitro study.

The oxidative state of glutathione in red blood cells (RBC) and plasma of diabetic patients and of age-matched volunteers has been studied. Oxidized glutathione (GSSG) levels in plasma from diabetic subjects were higher than those from controls (17.2 +/- 2.5 and 3.3 +/- 0.4 micrograms/ml, respectively). This phenomenon was evident also in in vitro experiments: incubated RBC from diabetic patients released very high amounts of GSSG in medium. Thus, erythrocytes are responsible for the enhanced amounts of GSSG found in plasma from diabetic patients. The fall in the conversion of GSSG to reduced glutathione in RBC could be due to a reduced activity of the glucose-6-phosphate dehydrogenase (G6PDH) enzyme which has been observed in diabetic patients. In this way, G6PDH supplies reduced amounts of NADPH to the glutathione reductase enzyme affecting the integrity of the glutathione system; on the other hand, the activation by glucose of the polyol pathway also reduces the levels of NADPH for the glutathione reductase enzyme.