Glutathione depleting drugs, antioxidants and intestinal calcium absorption

World J Gastroenterol. 2018 Nov 28;24(44):4979-4988. doi: 10.3748/wjg.v24.i44.4979.

Abstract

Glutathione (GSH) is a tripeptide that constitutes one of the main intracellular reducing compounds. The normal content of GSH in the intestine is essential to optimize the intestinal Ca2+ absorption. The use of GSH depleting drugs such as DL-buthionine-S,R-sulfoximine, menadione or vitamin K3, sodium deoxycholate or diets enriched in fructose, which induce several features of the metabolic syndrome, produce inhibition of the intestinal Ca2+ absorption. The GSH depleting drugs switch the redox state towards an oxidant condition provoking oxidative/nitrosative stress and inflammation, which lead to apoptosis and/or autophagy of the enterocytes. Either the transcellular Ca2+ transport or the paracellular Ca2+ route are altered by GSH depleting drugs. The gene and/or protein expression of transporters involved in the transcellular Ca2+ pathway are decreased. The flavonoids quercetin and naringin highly abrogate the inhibition of intestinal Ca2+ absorption, not only by restoration of the GSH levels in the intestine but also by their anti-apoptotic properties. Ursodeoxycholic acid, melatonin and glutamine also block the inhibition of Ca2+ transport caused by GSH depleting drugs. The use of any of these antioxidants to ameliorate the intestinal Ca2+ absorption under oxidant conditions associated with different pathologies in humans requires more investigation with regards to the safety, pharmacokinetics and pharmacodynamics of them.

Keywords: DL-buthionine-S,R-sulfoximine; Fructose rich diet; Glutamine; Glutathione; Melatonin; Menadione; Naringin; Quercetin; Sodium deoxycholate; Transcellular and paracellular Ca2+pathways; Ursodeoxycholic acid.

Publication types

  • Review

MeSH terms

  • Antimetabolites / adverse effects*
  • Antimetabolites / pharmacokinetics
  • Antioxidants / pharmacology*
  • Calcium / metabolism*
  • Glutathione / antagonists & inhibitors*
  • Glutathione / metabolism
  • Humans
  • Intestinal Absorption / drug effects*
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / metabolism
  • Oxidants / adverse effects
  • Oxidants / pharmacokinetics

Substances

  • Antimetabolites
  • Antioxidants
  • Oxidants
  • Glutathione
  • Calcium