L-2-oxothiazolidine-4-carboxylic acid (OTC) is a cysteine prodrug that maintains glutathione in tissues. Here, its effect on alcohol-induced liver injury in an enteral alcohol feeding model was investigated. Male Wistar rats were given control high-fat or ethanol containing diets enterally for 4 weeks. Treated rats received 500 mg/kg/d of dietary OTC. Ethanol delivery, weight gain, and the cyclic pattern of ethanol in the urine were not different between the OTC-ethanol and ethanol groups. After 4 weeks, serum aspartate transaminase (AST), necrosis and inflammation were elevated significantly by ethanol compared with appropriate high-fat controls, effects blocked by OTC. Moreover, ethanol elevated hepatic tumor necrosis factor ␣ (TNF-␣) messenger RNA (mRNA) and the nuclear transcription factor nuclear factor B (NFB) 2-3 fold. NFB in isolated Kupffer cells was also increased by ethanol. These effects were all blocked by OTC treatment. Additionally, superoxide production was higher in Kupffer cells isolated from ethanol-treated rats, an effect blunted by OTC. OTC also increased circulating glutathione (GSH) levels about 2-fold; however, GSH levels were not affected by ethanol or OTC in livers from the groups studied. Surprisingly, GSH was elevated by ethanol and OTC treatment in isolated Kupffer cells about 2-fold. Moreover, GSH (Ki-10 mol/L) and cysteinylglycine, but not oxidized glutathione (GSSG) or OTC, blunted the LPS-induced increase in calcium in isolated Kupffer cells, possibly by activating a glycine-gated chloride channel due to their structural similarity with glycine. Collectively, it is concluded that GSH is protective, in part, by increasing circulating GSH, which blunts activation of Kupffer cells via the glycine-gated chloride channel. (HEPATOLOGY 2000;31:391-398.)Kupffer cells release numerous mediators that participate in metabolic regulation, inflammation, and immune function. 1,2 Recent work from this laboratory has shown a central role for Kupffer cells in mechanisms of alcohol-induced liver injury. For example, when Kupffer cells were destroyed using gadolinium chloride (GdCl 3 ), injury caused by chronic alcohol administration in the Tsukamoto-French enteral alcohol feeding model was blocked. 3 Moreover, Kupffer cells are activated by bacterial endotoxin, and elimination of endotoxin with antibiotics 4 or Lactobacillus feeding 5 also diminished injury to the liver caused by alcohol. This concept was further strengthened by the observation that an antibody to tumor necrosis factor ␣ (TNF-␣) and a mouse lacking the TNF-receptor 1 6 exhibited diminished injury due to chronic ethanol 7 (for review see Thurman 8 ).Using the same enteral feeding model, Hirano et al. 9 showed that ethanol decreased hepatic glutathione (GSH) levels. Decreased glutathione occurs in many disease states including ischemia-reperfusion associated with heart disease. 10 Interestingly, they also showed that ethanol had a more pronounced effect on mitochondrial GSH content, and suggested that it could play an important role...