Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 28, 2026 44 minutes ago
A major review of acute respiratory distress syndrome (ARDS) suggests that depletion of glutathione, one of the body’s most important antioxidants, may be closely linked to worsening lung injury and could eventually help doctors identify patients approaching severe respiratory failure. ARDS affects an estimated 150,000–190,000 people annually in the United States. The study review was conducted by researchers from Western University of Health Sciences-USA.
Falling glutathione levels may provide an early biological warning of worsening oxidative lung injury and
respiratory failure in ARDS.
Antioxidant defenses collapse as ARDS worsens
Glutathione, or GSH, protects cells by neutralizing reactive oxygen species (ROS). In ARDS, excessive ROS can damage lung epithelial and endothelial cells, disrupt the barrier separating air sacs from blood vessels, promote inflammation and contribute to abnormal clotting. The review proposes that falling GSH may leave lung tissue increasingly vulnerable to this damaging cycle.
Earlier measurements highlighted the scale of the problem: GSH concentrations in epithelial lining fluid were reported at just 31.5 ± 8.4 micromolar in ARDS patients compared with 651 ± 103.1 micromolar in controls.
Lower glutathione tracks with greater illness severity
Among 96 participants in one COVID-19 study reviewed by the authors, average serum GSH fell progressively from 374.94 ± 41.15 micromoles/mL in healthy controls to 227.03 ± 36.91 in hospitalized non-ICU patients, 134.54 ± 38.11 in ICU patients without intubation and 102.11 ± 36.86 among intubated ICU patients. Meanwhile, oxidant levels rose sharply as illness became more severe.
Patients who died also had substantially lower average GSH than survivors—113.90 versus 188.12 micromoles/mL. However, these findings show an association rather than proving that glutathione independently predicts intubation.
As highlighted in this
Thailand Medical News report, researchers believe GSH could eventually complement oxygen saturation, PaO2/FiO2 ratios and other established measures when assessing deterioration.
Could restoring glutathione help?
Evidence reviewed also points toward potential treatment strategies. Trials involving N-acetylcysteine, which supports antioxidant defenses, reported improved oxygenation, while other studies investigated intravenous or liposomal glutathione. The evidence remains preliminary, and no validated GSH threshold currently exists for deciding when mechanical ventilation is required.
Conclusions
The review strengthens evidence connecting glutathione depletion with oxidative stress, inflammation, vascular injury and worsening ARDS. However, prospective studies are still essential to establish whether measuring GSH can reliably predict respiratory deterioration or guide treatment before mechanical ventilation becomes necessary.
The study findings
were published in the peer reviewed International Journal of Molecular Sciences.
https://www.mdpi.com/1422-0067/27/19/8592
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https://www.thailandmedical.news/articles/coronavirus
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