STUDY OF THE CHEMICAL AND METABOLIC CHANGES IN PLASMA GLUTATHIONE (GSH) OF HUMAN BLOOD AFTER LITHIUM INTRODUCTION
1Haroon Khan, 1Muhammad Farid Khan, 2Syed Umer Jan*, 1Kamran Ahmad Khan and 1Shefaat Ullah Shah
1Faculty of Pharmacy, Gomal University Dera Ismail Khan (KPK) Pakistan 2 Department of Pharmacy, University of Balochistan, Quetta Pakistan
Keywords: Lithium, Glutathione (GSH), Blood, Plasma, Ellman’s method
Abstract

Lithium remains a mainstay in the acute and prophylactic treatment of bipolar affective disorder. It is used in the augmentation of antidepressant treatment and, less frequently, in the augmentation of antipsychotic treatment of schizophrenia. It is reported to have specific anti-suicidal effects. Systematic reviews by the Cochrane collaboration and others have examined the evidence base or its use in these contexts. Thus it is interesting to study the effect of Lithium on the Glutathione. The effect of Lithium on the chemical status of the glutathione in plasma has been studied using Ellman’s method. The effect of Lithium on the chemical status of glutathione was determined in plasma for concentration and time dependent effects. There was found a drastic effect on decreasing the concentration of glutathione in plasma as the concentration is increased and time has passed. The decrease in the Glutathione level was concentration and time of interaction dependent, probably due to oxidation of GSH to corresponding disulphide (GSSG).In this paper the effect of Lithium metal on thiol /GSH level was discussed in vitro, which in principal may present a model of in vivo reaction.

Article Information

Identifiers and Pagination:
Year:2011
Volume:3
First Page:201
Last Page:211
Publisher Id:JAppPharm (2011 ). 3. 201-211
Article History:
Received:January 27, 2011
Accepted:April 7, 2011
Collection year:2011
First Published:April 13, 2011

INTRODUCTION:
Glutathione (g-glutamylcysteinylglycine, GSH) is a sulfhydryl (-SH) antioxidant, antitoxin, and
enzyme cofactor. Glutathione is ubiquitous in animals, plants, and microorganisms, and being
water soluble is found mainly in the cell cytosol and other aqueous phases of the living system
(Kosower and Kosower, 1978; Kidd, 1991; Lomaestro and Malone, 1995; Meister,
1976).Glutathione exists in two forms: The antioxidant "Reduced Glutathione" tripeptide is conventionally called Glutathione and abbreviated GSH; the oxidized form is a sulfur-sulfur
linked compound, known as glutathione disulfide or GSSG. The GSSG/GSH ratio may be a
sensitive indicator of oxidative stress. Glutathione synthesis occurs within cells in two closely
linked, enzymatically controlled reactions that utilize ATP and draw on nonessential amino acids
as substrates. First, cysteine and glutamate are combined (by the enzyme gamma-glutamyl
cysteinyl synthetase, with availability of cysteine usually being the rate-limiting factor. Cysteine
is generated from the essential amino acid methionine, from the degradation of dietary protein, or
from turnover of endogenous proteins. The buildup of GSH acts to feedback-inhibit this enzyme,
thereby helping to ensure homeostatic control over GSH synthesis.GSH has potent electrondonating
capacity, as indicated by the high negative redox potential of the GSH/GSSH "redox
couple" (E'0 =-0.33v) (Lewin, 1976) .Its high redox potential renders GSH both a potent
antioxidant and a convenient cofactor for enzymatic reactions that require readily available
electron pairs (Kehrer and lund, 1994). The reducing power of GSH is a measure of its free
radical scavenging, electron-donating, and sulfhydryl-donating capacity.
The reduced Glutathione molecule consists of three amino acids - Glutamic acid, Cysteine, and
Glycine - covalently joined end-to-end. The sulfhydryl (-SH) group, which gives the molecule its
electron-donating character, comes from the cysteine residue.Glutathione is present inside cells
mainly in its reduced (electron-rich, antioxidant) GSH form. In the healthy cell GSSG, the
oxidized (electron-poor) form, rarely exceeds 10 percent of total cell glutathione (Kosower and
Kosower, 1978). Intracellular GSH status appears to be a sensitive indicator of the cell's overall
health, and of its ability to resist toxic challenge. Experimental GSH depletion can trigger suicide
of the cell by a process known as apoptosis (Duke et al., 1996; Slater et al., 1995). Lithium in
pharmacology refers to the lithium ion, Li+, used as a drug (Hecht at el., 2000). Lithium is
administered in a number of chemical salts of lithium, which are used primarily in the treatment
of Bipolar disorder as mood stabilizing drugs. In bipolar disorder they have a role in the treatment
of depression and mania acutely and in the long term. As a mood stabiliser, lithium is probably
more effective in preventing mania than depression, and may reduce the risk of suicide. In
depression alone (unipolar disorder) lithium can be used to augment other antidepressants.
Lithium carbonate (Li2CO3), sold as is the most commonly prescribed, whilst the citrate salt
lithium citrate (Li3C6H5O7), the sulfate salt lithium sulfate (Li2SO4), aspartate and the orotate salt
lithium orotate are alternatives (www.nlm.nih.gov). Lithium has affinity for the glutathione
present in aqueous phases of blood. This affinity is mainly formed between metal and sulfhydryl
groups of glutathione (Quig, 1998).This affinity can cause a depletion of the reduced form of
glutathione in the blood ,but with the depletion of the glutathione, GSH synthesizing systems start
making more GSH from cysteine via the -glutamyl cycle but if GSH is usually not effectively
supplied, however, if GSH depletion continues because of chronic metal exposure (Quig, 1998;
Hultberg et al., 2001 Stohs and Blichi,1993) then the pharmacological benefits of the metal being
used for the help of body defenses can be harmful in nature to the body defense system . The
following study makes a design to see the effects of Lithium, in respect of concentration and time,
on glutathione level in plasma.
MATERIALS AND METHODS
L.Glutathione (GSH) (Fluka), Lithium Carbonate (Across, Belgium), Di,thiobis, dinitrobenzoic
acid (DTNB), U.V 1601 spectrophotometer (Shimadzu). PH Meter: Model NOV-210, Nova
Scientific Company Ltd
ISOLATION OF PLASMA
Sample of 5 ml of human venous blood was treated with heparin to prevent clotting was collected.
The blood was centrifuge on H-200 centrifuge at 10,000rmp for 2 minutes. The plasma was
removed with Pasteur pipette. One ml of plasma were incubated for different concentration and
time interval with I ml of metal, and analyzed for GSH level.
Determination of GSH in Plasma
The assay of GSH with DTNB was performed followed a standard Ellman’s method for plasma
of blood.2.3ml of potassium phosphate (0.2M,PH 7.6) buffer was taken in the cell and/or cuvete
followed addition of 0.2ml aqueous solution or plasma of blood .To it 0.5ml DTNB (0.001M) in
a buffer was added. An absorbance of reaction product in cuvette was read after 5 minutes at 412
nm using shimadzo 1601 UV/Visible double bean spectrophotometer and GSH level was
determined, from standard curve of reduced GSH obtained with 0.2, 0.4, 0.6, 0.8 and 1mM GSH
concentration.
Standard Curve for Glutathione
200µl of 0.2, 0.4, 0.6, 0.8 and 1mM solutions of glutathione was added to 2.3ml of phosphate
buffer pH 7.6, followed by the addition of 0.5ml of 1mM DTNB Stock solution. The mixtures
were shaken thoroughly and incubated for 5 minutes at 300C. Absorbances were taken after 5
minutes at fixed wavelength of 412nm.
Effect of different concentrations of Lithium Carbonate on the chemical Status of
Glutathione (GSH) in plasma of Human Blood
Blank was prepared in which GSH was omitted. Standard curve was constructed by plotting the
change of absorbance versus final concentration of GSH in the mixture. Straight line was drawn
by using linear regression analysis. The correlation coefficient of plot was 0.9984. Standard curve
was obtained as shown in the figure 1
To 1ml (1000ml) of plasma taken in five separate test tubes, 1ml (1000ml) of different
concentrations of 0.4, 0.8, 1.2, 1.6 and 2mM solution of Lithium carbonate were added separately
and shacked. Five separate test tubes was prepared with 0.2ml (200ml) Lithium carbonate plus
plasma mixture from each previously made five tubes diluted with 2.3ml (2300ml) of phosphate
Buffer pH 7.6 and added 0.5ml (500ml) of 1mM DTNB stock solution. A control for plasma was
also prepared by taking 1ml (1000ml) of plasma in a test tube and diluted with 1ml (1000ml) of
phosphate buffer pH 7.6.The effect of Lithium carbonate on the chemical status of glutathione in
plasma was studied in terms of determination of concentration of GSH in mixtures by a well 
Effect of Lithium Carbonate on the Chemical Status of Glutathione (GSH) in Plasma with
time
To 1ml (1000ml) of Plasma taken in a test tube, 1ml (1000ml) of 2mM solution of Lithium
carbonate was added and shaked. The final concentration of Lithium carbonate was 1mM
(500mM). A test tube with 0.2ml (200ml) Lithium carbonate plus plasma mixture was prepared
from previously made test tube diluted with 2.3ml (2300ml) of phosphate buffer pH 7.6 and added
0.5ml (500ml) of 1mM DTNB stock solution. The final concentration of Lithium carbonate was
0.03333mM (33.33mM).A control for plasma was also prepared by taking 1ml (1000ml) of plasma
in a test tube and diluted with 1ml (1000ml) of phosphate buffer pH 7.6.The effect of Lithium
carbonate glutathione level in plasma was studied in terms of determination of concentration of
GSH in mixtures by a well known Ellman’s method, as mentioned in standard curve for GSH.
The absorbances were read at 0, 30, 60, 90, 120, 150 minutes after preparing mixture (1ml of
plasma plus 1ml of Aluminium sulphate).The concentrations of GSH in plasma were determined
from the glutathione standard curve.
RESULTS
Effect of Lithium on the Chemical Status of Glutathione (GSH) in Plasma
Effect of Lithium metal on the chemical status of glutathione present in plasma was studied in
term of determination of concentration of glutathione.
Lithium metal caused a decrease in the concentration of glutathione present in plasma. GSH in plasma as
the concentration of metal increased. Different concentrations of Lithium cause a gradual decrease in the
concentration of glutathione.
Table 1. Effect of different concentrations of Lithium Carbonate on the chemical Status of
Glutathione (GSH) in Plasma Statistical Analysis for Effect of Lithium on the Chemical Status of Glutathione (GSH) in
Plasma
Statistical approach for the effect of Lithium on the chemical status of GSH was also conducted
for the concentration and time dependent effects.
The paired comparison T-test (Table 5) of concentration dependent effect of Lithium and GSH
blank gave the decision that there is an effect of Lithium on the chemical status of GSH in
plasma with increase in concentration of Lithium, as compared to GSH blank solution treatment.
Table 5- Paired comparison t-test for concentration dependent effect of Li2Co3
Similarly the paired comparison T-test (Table 6) of time dependent effect of Lithium and GSH
blank gave the decision that there is an effect of Lithium on the chemical status of GSH in plasma
as the passage of time is increased with a specific concentration of Lithium as compared to GSH
blank solution treatment
Table 6- Paired DISCUSSION
There is increasing interest in glutathione due to its varied physiological and pharmacological
properties including detoxification through participation in the redox system, activation of SHenzymes,
co-enzymatic action and conjugation. Lithium has been found to play a role in apoptosis
(gene-directed cell death), a critical cellular regulatory process with implications for growth and
development, as well as a number of chronic diseases. Cells in the salivary gland, prostate,
immune system and intestine can secrete Lithium. Thus it was of interest to study the interaction
of this metal in vitro to establish further scientific data. This scientific data about the interaction
and the effect of Lithium on the chemical modulation of GSH will enable us to understand further
the role of, Lithium and GSH and strengthen our knowledge about their therapeutic uses in many
diseases. The effect of Lithium was studied for the concentration and time dependent effects on
the chemical status of glutathione and was found that the concentration of reduced glutathione
was decreased with increasing concentration of Lithium metal in solution and with the passage of
time, respectively. The following sequences of reactions are suggested to be happened in the
experiment.
Equation
GSH + Lithium (Li)  GS-Li
The results also suggested that there was a possibility of formation of intermediate or conjugate
between Lithium and GSH. However it was not possible to estimate or determined those conjugates under those conditions .Since both GSH and Lithium, is biological active compounds.
It was of interest to study the possible interaction of this metal in vitro as a model of in vivo
interaction.
CONCLUSION
The tripeptide thiol glutathione has facile electron-donating capacity, linked to it sulfhydryl (SH)
group. Glutathione is important water - phase antioxidant and essential cofactor for antioxidant
enzyme. It provides protection also for the mitochondria Liainst endogenous radicals. Its high
electron donating capacity combined with its high molecular concentration endows (GSH) with
great reducing power, which is used to regulate a complex thiol-exchange system..Different
concentration of Lithium metal caused a gradual decreased in the concentration of Glutathione
(GSH) in plasma. Effect of Lithium on the chemical status of glutathione was also studied for the
time dependency and noted that the concentration of glutathione gradually decreased as the time
passes from 0 minute interval of time to 150 minutes in plasma.
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Welcome to the research group of Prof. Dr. Cornelia M. Keck in Marburg. Cornelia M. Keck is a pharmacist and obtained her PhD in 2006 from the Freie Universität (FU) in Berlin. In 2009 she was appointed as Adjunct Professor for Pharmaceutical and Nutritional Nanotechnology at the University Putra Malaysia (UPM) and in 2011 she obtained her Venia legendi (Habilitation) at the Freie Universität Berlin and was appointed as a Professor for Pharmacology and Pharmaceutics at the University of Applied Sciences Kaiserslautern. Since 2016 she is Professor of Pharmaceutics and Biopharmaceutics at the Philipps-Universität Marburg. Her field of research is the development and characterization of innovative nanocarriers for improved delivery of poorly soluble actives for healthcare and cosmetics. Prof. Keck is executive board member of the German Association of Nanotechnology (Deutscher Verband Nanotechnologie), Vize-chairman of the unit „Dermocosmetics“ at the German Society of Dermopharmacy, active member in many pharmaceutical societies and member of the BfR Committee for Cosmetics at the Federal Institute for Risk Assessment (BfR).

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