Inhibition of glutaminolysis prevented GSH synthesis and pyruvate transamination in shock rat RBCs, liver, and lung. (A) An overview of the proposed mechanism. (B) Metabolomics analyses revealed that, upon treatment with the glutaminase inhibitor CB-839, baseline and 15-minute postshock rats undergoing severe HS had significant impairments in GSH synthesis and alanine transamination that correlated with exacerbation of RBC accumulation of lactate and succinate (shock vs shock+CB-839). (C-D) A detailed overview of significant changes in glutamate, alanine, lactate, GSH, succinate in RBCs (C), and alanine in liver and lungs (D) is shown in the form of box-and-whisker plots. ETC, electron transport chain.