Glutathione (Atopolan): An Adjuvant Drug for Anticancer Therapy and Hepatitis B
Glutathione (brand name Atopolan; available as both injection and tablets) is a commonly used adjuvant drug in oncology. In the body, glutathione exists in two forms: reduced glutathione (GSH) and oxidized glutathione (GSSG). Its active component is reduced glutathione, which participates in redox processes within the body. The chemical name of reduced glutathione is N-(N-L-γ-glutamyl-L-cysteinyl)glycine; its molecular formula is C10H17N3O6S, and its molecular weight is 307.33. Reduced glutathione is soluble in water, dilute alcohol, liquid ammonia, and methylformamide, and insoluble in alcohol, ether, and acetone.
Glutathione is a tripeptide composed of glutamic acid, cystine, and glycine. It is a coenzyme for glyceraldehyde phosphate dehydrogenase and a cofactor for glyoxalase and triose phosphate dehydrogenase. It participates in the tricarboxylic acid cycle and glucose metabolism, enabling the body to obtain high energy. Glutathione activates various enzymes, thereby promoting the metabolism of carbohydrates, fats, and proteins, and can also influence cellular metabolic processes; it is an important intracellular metabolic regulator. The multiple enzymes activated in the body by reduced glutathione constitute an important detoxifying substance that protects the body from harmful agents such as iodoacetic acid, mustard gas, free radicals (e.g., superoxide anion), heavy metals (e.g., mercury, lead), and epoxides. Therefore glutathione is also used in the rescue of heavy metal and organic solvent poisoning.
Reduced glutathione is an important antioxidant; its most important role is in preventing liver damage. In drug classification it belongs to the category of adjuvant anticancer medication. During radiotherapy and chemotherapy, the use of reduced glutathione not only protects the liver but also prevents and treats radiation injury, leukopenia, and radiation-induced inflammation of bone marrow tissue.
Glutathione can protect the liver not only during chemotherapy and radiotherapy but also during alcohol intoxication and when taking Chinese herbal medicines or other hepatotoxic drugs (such as anti-tuberculosis drugs, anticancer drugs, and antidepressants). Glutathione also has a good protective effect against liver damage caused by viral hepatitis such as hepatitis B and hepatitis C; the package insert for glutathione tablets (Atopolan) states that it is suitable for hepatoprotective treatment of hepatitis B.
Glutathione is widely present in animal and plant cells, with the highest concentrations in the liver and the lens; we can obtain it from food. However, glutathione can now also be produced by chemical synthesis or fermentation, making it more conveniently available.
Glutathione also has eye-protecting and skin-whitening effects. It promotes the metabolism of ocular tissues, can inhibit the instability of lens protein sulfhydryl groups, and prevents the development of cataracts and retinal diseases; it can therefore be used in keratitis and corneal trauma to protect vision. However, to achieve the preventive effect against such diseases, glutathione needs to be used regularly before old age. After taking glutathione, problems of skin pigmentation (such as tinea versicolor, age spots, and chloasma) can also be alleviated.