Inflammatory lung diseases are characterized by chronic inflammation and oxidant/antioxidant imbalance, a major cause of cell damage. The development of an oxidant/antioxidant imbalance in lung inflammation may activate redoxâsensitive transcription factors such as nuclear factorâÎșB, and activator proteinâ1 (APâ1), which regulate the genes for proâinflammatory mediators and protective antioxidant genes. Glutathione (GSH), a ubiquitous tripeptide thiol, is a vital intraâ and extracellular protective antioxidant against oxidative/nitrosative stresses, which plays a key role in the control of proâinflammatory processes in the lungs. Recent findings have suggested that GSH is important in immune modulation, remodelling of the extracellular matrix, apoptosis and mitochondrial respiration. The rateâlimiting enzyme in GSH synthesis is Îłâglutamylcysteine synthetase (ÎłâGCS). The human ÎłâGCS heavy and light subunits are regulated by APâ1 and antioxidant response elements and are modulated by oxidants, phenolic antioxidants, growth factors, and inflammatory and antiâinflammatory agents in lung cells.
Alterations in alveolar and lung GSH metabolism are widely recognized as a central feature of many inflammatory lung diseases such as idiopathic pulmonary fibrosis, acute respiratory distress syndrome, cystic fibrosis and asthma. The imbalance and/or genetic variation in antioxidant ÎłâGCS and proâinflammatory versus antioxidant genes in response to oxidative stress and inflammation in some individuals may render them more susceptible to lung inflammation. Knowledge of the mechanisms of GSH regulation and balance between the release and expression of proâ and antiâinflammatory mediators could lead to the development of novel therapies based on the pharmacological manipulation of the production as well as gene transfer of this important antioxidant in lung inflammation and injury.
This review describes the redox control and involvement of nuclear factorâÎșB and activator proteinâ1 in the regulation of cellular glutathione and Îłâglutamylcysteine synthetase under conditions of oxidative stress and inflammation, the role of glutathione in oxidantâmediated susceptibility/tolerance, Îłâglutamylcysteine synthetase genetic susceptibility and the potential therapeutic role of glutathione and its precursors in protecting against lung oxidant stress, inflammation and injury.