Dietary supplementation with cysteine prodrugs selectively restores tissue glutathione levels and redox status in protein-malnourished mice

Protein malnutrition (PM) is a major health problem in the world. PM compromises antioxidant defense in the body. In particular, PM decreases tissue glutathione (GSH) levels. A high protein diet was found to restore tissue GSH levels in animal studies, however it is not recommended for the early phase of PM rehabilitation. Therefore, using dietary supplementation to restore tissue GSH without giving a high protein diet may be an adjunct therapy that helps improve antioxidant status during the early rehabilitation of PM. In this study, we systematically compared the efficacy of dietary supplementation of four cysteine prodrugs: N-acetylcysteine, L-2-oxo-4-thiazolidine-carboxylate, methionine, and GSH, on tissue GSH in mice fed a protein-deficient (0.5%) diet. Results showed that dietary supplementation of cysteine prodrugs to PM mice restored GSH levels in liver, lung, heart and spleen, but not in colon. GSH and GSSG levels in brain and kidney were not affected by cysteine prodrug or PM. Supplementation also restored the redox status in liver and heart (based on GSH/GSSG), and in liver and spleen (based on GSSG/2GSH reduction potential). This suggests that the restoration of GSH levels and redox status by cysteine prodrugs are tissue-specific, and that the two indicators of redox status are not always interchangeable. However, all four prodrugs exhibited similar GSH-enhancing capacities, showing no prodrug-specificity as seen in cell culture studies. In conclusion, this study provided information that may be useful in a clinical setting where a short-term oral supplementation of cysteine prodrugs is necessary for the early rehabilitation of PM patients.