Figure 3
A plausible series of reactions that could explain the lack of resistance of G6PD-deficient red cells to oxidative stress. The interaction of drugs with red cells produces hydrogen peroxide, either directly or by way of reactive oxygen species. Glutathione removes the peroxide through the glutathione peroxidase reaction and continues to do so as long as the oxidized glutathione formed is able to be reduced through the glutathione reductase reaction. The latter reaction, requiring continual reduction of NADP to NADPH, is dependent on the G6PD reaction and fails in red cells deficient in this enzyme. (Reprinted from Beutler68 with permission from FASEB.)
