Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy

Abstract Background In small cell lung cancer (SCLC), oxidative stress disrupts redox balance and contributes to tumor progression and treatment resistance through DNA damage, inflammation, and tumorigenesis. Thiol compounds such as glutathione (GSH) and cysteine (CyS) together with their oxidized f...

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Main Authors: Azra Guzonjić, Milkica Crevar, Ivana Simić, Natalija Samardzić, Vesna Ćeriman Krstić, Jelena Kotur Stevuljević, Dragana Jovanović
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-03251-2
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author Azra Guzonjić
Milkica Crevar
Ivana Simić
Natalija Samardzić
Vesna Ćeriman Krstić
Jelena Kotur Stevuljević
Dragana Jovanović
author_facet Azra Guzonjić
Milkica Crevar
Ivana Simić
Natalija Samardzić
Vesna Ćeriman Krstić
Jelena Kotur Stevuljević
Dragana Jovanović
author_sort Azra Guzonjić
collection DOAJ
description Abstract Background In small cell lung cancer (SCLC), oxidative stress disrupts redox balance and contributes to tumor progression and treatment resistance through DNA damage, inflammation, and tumorigenesis. Thiol compounds such as glutathione (GSH) and cysteine (CyS) together with their oxidized forms (GSSG and CySS) serve as markers of oxidative stress. The aim of this study was to investigate changes in GSH/GSSG and CyS/CySS ratios during chemotherapy and evaluate their potential as prognostic indicators in SCLC. Materials and methods In this longitudinal study, redox biomarkers (GSH/GSSG and CyS/CySS ratios) were investigated in 60 stage III/IV SCLC patients receiving cisplatin-etoposide chemotherapy. Plasma samples were collected before chemotherapy, after two cycles and after four cycles and analyzed by LC-MS/MS. Results Significant redox changes were observed during chemotherapy. The GSH/GSSG ratio decreased after two cycles (p = 0.029) and increased after four cycles (p = 0.002). The same trend was observed for CyS/CySS dynamics (p = 0.031 and p = 0.030, respectively). The Survivors showed a recovery of the redox balance, while the deceased patients showed persistently lower ratios. Kaplan-Meier analysis showed that a higher GSH/GSSG ratio before treatment (p = 0.037) predicted better survival. A positive correlation was found between GSH/GSSG and CyS/CySS ratios (ρ = 0.306, p = 0.019). Conclusions This study demonstrates that redox imbalance reflected in GSH/GSSG and CyS/CySS ratios is an important factor for SCLC treatment response and survival. Higher GSH/GSSG ratios before treatment are associated with improved survival, indicating the potential of redox markers as prognostic tools in SCLC.
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spelling doaj-art-aefb2c103b6248d9b96ce55c56a41e1e2025-08-20T03:42:57ZengSpringerDiscover Oncology2730-60112025-07-0116111310.1007/s12672-025-03251-2Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapyAzra Guzonjić0Milkica Crevar1Ivana Simić2Natalija Samardzić3Vesna Ćeriman Krstić4Jelena Kotur Stevuljević5Dragana Jovanović6Faculty of Pharmacy, Department for Medical Biochemistry, University of BelgradeFaculty of Pharmacy, Department of Pharmaceutical Chemistry, University of BelgradeMerck Sharp & Dohme d.o.o, Medical AffairsClinic for pulmonology, University Clinical Center of SerbiaClinic for pulmonology, University Clinical Center of SerbiaFaculty of Pharmacy, Department for Medical Biochemistry, University of BelgradeInternal Medicine Clinic “Akta Medica”, Cara Nikolaja IIAbstract Background In small cell lung cancer (SCLC), oxidative stress disrupts redox balance and contributes to tumor progression and treatment resistance through DNA damage, inflammation, and tumorigenesis. Thiol compounds such as glutathione (GSH) and cysteine (CyS) together with their oxidized forms (GSSG and CySS) serve as markers of oxidative stress. The aim of this study was to investigate changes in GSH/GSSG and CyS/CySS ratios during chemotherapy and evaluate their potential as prognostic indicators in SCLC. Materials and methods In this longitudinal study, redox biomarkers (GSH/GSSG and CyS/CySS ratios) were investigated in 60 stage III/IV SCLC patients receiving cisplatin-etoposide chemotherapy. Plasma samples were collected before chemotherapy, after two cycles and after four cycles and analyzed by LC-MS/MS. Results Significant redox changes were observed during chemotherapy. The GSH/GSSG ratio decreased after two cycles (p = 0.029) and increased after four cycles (p = 0.002). The same trend was observed for CyS/CySS dynamics (p = 0.031 and p = 0.030, respectively). The Survivors showed a recovery of the redox balance, while the deceased patients showed persistently lower ratios. Kaplan-Meier analysis showed that a higher GSH/GSSG ratio before treatment (p = 0.037) predicted better survival. A positive correlation was found between GSH/GSSG and CyS/CySS ratios (ρ = 0.306, p = 0.019). Conclusions This study demonstrates that redox imbalance reflected in GSH/GSSG and CyS/CySS ratios is an important factor for SCLC treatment response and survival. Higher GSH/GSSG ratios before treatment are associated with improved survival, indicating the potential of redox markers as prognostic tools in SCLC.https://doi.org/10.1007/s12672-025-03251-2Oxidative stressLung cancerRedox imbalancePrognostic biomarkers
spellingShingle Azra Guzonjić
Milkica Crevar
Ivana Simić
Natalija Samardzić
Vesna Ćeriman Krstić
Jelena Kotur Stevuljević
Dragana Jovanović
Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy
Discover Oncology
Oxidative stress
Lung cancer
Redox imbalance
Prognostic biomarkers
title Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy
title_full Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy
title_fullStr Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy
title_full_unstemmed Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy
title_short Alterations in GSH/GSSG and CyS/CySS redox status in small cell lung cancer patients undergoing chemotherapy
title_sort alterations in gsh gssg and cys cyss redox status in small cell lung cancer patients undergoing chemotherapy
topic Oxidative stress
Lung cancer
Redox imbalance
Prognostic biomarkers
url https://doi.org/10.1007/s12672-025-03251-2
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