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FIGURE 4 This is complicated because as a polar, charged tripeptide, transport of GSH is significantly inhibited by the blood-brain barrier (BBB), thus limiting effective delivery to brain-resident immune cells such as microglia which are central drivers of neuroinflammatory pathology ( As many treatments for neurological conditions have been hampered by limited permeability of the BBB, significant emphasis has been placed on research directed towards advanced drug delivery methods ( More targeted CNS uptake has been attempted by conjugating polymeric nanoparticles with ligands like transferrin or lactoferrin ( As a combined medicinal treatment for viral infections such as COVID-19 or influenza, administration of GSH or NAC in conjunction with established anti-viral treatment has been found to improve lymphocyte response, reduce pro-inflammatory cytokines and reduce cellular oxidative injury ( As a pharmacologic therapeutic, optimizing the efficacy of GSH and minimizing its unintended effects means it is crucial to determine the correct timing, dose, and disease context ( In addition to being a therapeutic target, oxidative stress has been shown to decrease the GSH:GSSG ratio which has proven useful as a clinically accessible, pharmacodynamic biomarker of immune redox tone for conditions such as malignancy ( GSH has also shown promise as a redox-based biomarker for neurodegenerative disease states

Pathogens 14(8):780 Guz NR, Stermitz FR, Johnson JB, Beeson TD, Willen S, Hsiang JF, Lewis K (2001) Flavonolignan and flavone inhibitors of a Staphylococcus aureus multidrug resistance pump: structure activity relationships

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