title: Plasma glutathione reductase activity and prognosis of septic shock.
abstract: BACKGROUND
  Our aim was to investigate whether plasma glutathione reductase (GR) activity is well correlated with the erythrocyte-reduced glutathione (GSH)/glutathione disulfide (GSSG) ratio and is associated with the mortality of septic shock.
  
  
  METHODS
  This study was conducted on male Sprague-Dawley rats and patients admitted to the intensive care unit with septic shock. To induce endotoxemia in rats, vehicle or lipopolysaccharide (LPS) at dosages of 5 or 10 mg/kg were injected into a tail vein. Animals were then euthanized 6 h post-LPS. Based on the 28-d mortality, the enrolled patients were divided into the survivors and nonsurvivors. We obtained blood samples from patients at admission (0 h) and 24 h after admission to the intensive care unit.
  
  
  RESULTS
  In endotoxemic rats, the erythrocyte GSH/GSSG ratio, erythrocyte GR activity, and plasma GR activity in the 10 mg/kg of LPS group were lower than those in the sham and 5 mg/kg of LPS groups. In patients with septic shock, decrease in plasma GR activity at 24 h was independently associated with an increase in 28-d mortality (odds ratio, 0.828; 95% confidence interval, 0.690-0.992, P = 0.041). Plasma GR activity was correlated with erythrocyte GR activity (Spearman ρ = 0.549, P < 0.001) and the erythrocyte GSH/GSSG ratio (rho = 0.367, P = 0.009) at 24 h.
  
  
  CONCLUSIONS
  Plasma GR activity was well correlated with erythrocyte GR activity and the erythrocyte GSH/GSSG ratio, and a decrease in plasma GR activity was associated with an increase in the mortality of septic shock patients.
authors: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Jae Seong
authors: JS
authors: Kim
authors: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. Electronic address: kwy711@hanmail.net.
authors: Woon Yong
authors: WY
authors: Kwon
authors: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Gil Joon
authors: GJ
authors: Suh
authors: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Kyung Su
authors: KS
authors: Kim
authors: Department of Emergency Medicine, National Medical Center, Seoul, Korea.
authors: Yoon Sun
authors: YS
authors: Jung
authors: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Sung Hee
authors: SH
authors: Kim
authors: Department of Emergency Medicine, Incheon Sarang Hospital, Incheon, Korea.
authors: So Eun
authors: SE
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D005978:Glutathione / Q000097:blood; D019803:Glutathione Disulfide / Q000097:blood; D005980:Glutathione Reductase / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051381:Rats; D017207:Rats, Sprague-Dawley; D012772:Shock, Septic / Q000097:blood / Q000201:enzymology / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D005980:Glutathione Reductase; D005978:Glutathione; D019803:Glutathione Disulfide
keywords: Glutathione; Glutathione reductase; Mortality; Oxidation reduction; Oxidative stress; Septic shock