Glutathione: Biosynthesis, metabolism and clinical perspectives

Glutathione (GSH) is the main thiol antioxidant involved in redox balance, detoxification, immune regulation, and mitochondrial function. Disturbances in GSH metabolism contribute to cancer, neurodegeneration, cardiometabolic, and hepatic/renal diseases. Mechanisms such as ferroptosis, mitochondrial transport, and S-glutathionylation highlight translational relevance of GSH metabolism. Analytical challenges in methodology are present with liquid chromatography/mass spectroscopy as the gold standard but limited by accessibility. Future priorities include randomized trials and in vivo imaging, which may pave the way for glutathionecentered personalized medicine. In this review, we have included biosynthesis and metabolism of GSH as well as its biochemical roles related to nutrition, health, and disease. Finally, we have discussed measurement methods and future therapeutic approaches based on GSH metabolism.