Glutathione level in community-acquired pneumonia patients

Glutathione, in its thiol-reduced form (GSH), is the most abundant antioxidant in the airway epithelial lining fluid. It acts as a vital intra- and extracellular antioxidant protecting oxidative/nitrosative stress, interceding the pro-inflammatory processes in the lungs. Aim: Relationship between pneumonia severity and GSH level have been studied. Methods: A case-conrol study took place at P. Stradins Clinical University hospital, Riga, Latvia. Community-acquired pneumonia (CAP) patients with no underlying chronic heart failure (n=32), both males and females of average age 69,0+7,2 and healthy control patients matched for age (n=20) were recruited. CURB 65 (confusion, uremia, respiratory rate, BP, age ≥ 65 years) score was used for CAP severity assessment. The level of plasma GSH was determined. CAP clinical pattern was followed up for 3 weeks. Results: Being compared to control group, GSH level was reduced in CAP patients (mean GSH was 1.12+ 0,22 mmol/L versus 1.60+0,16 mmol/L accordingly). There was no correlation between GSH level and CAP severity by CURB65. However, in 8 patients respiratory failure (RF) has developed. All the patients, in whom RF has developed, demonstrated GSH level below 1,1 mmol/L on admission. Conclusions: A low concentration of plasma GSH indicating low antioxidant capacity could act as a marker for inflammation-related OS in CAP patients for its management and/or risk of complications stratification.