Faruk DANIŞ, Murat ALIŞIK, Kaan ÇELİK, Özgür Mehmet YİS
Experimental Biomedical Research - 2026;9(4):302-313
Aim: To concurrently assess serum thiol-disulfide and erythrocyte glutathione redox status in patients with acute ischemic stroke and determine their associations with stroke severity, infarct volume, and 90-day functional outcome. Method: In this prospective case-control study, 85 stroke patients sampled within 24 hours of onset and 79 healthy controls were studied. Native and total thiol were measured by an automated assay and reduced (GSH) and total glutathione by a validated colorimetric method, with disulfide and oxidized glutathione (GSSG) derived by calculation. Markers were compared between groups with effect sizes and age- and sex-adjustment, correlated with NIHSS and infarct volume, and tested against poor 90-day outcome (modified Rankin Scale 3-6) in exploratory analyses. Results: Both systems shifted toward oxidation. Native and total thiol were lower and the disulfide fraction higher; the glutathione system shifted most, with lower GSH, higher GSSG, and a markedly higher GSSG/GSH ratio (0.119 vs 0.046; rank-biserial r = 0.88; adjusted p<0.001). No marker correlated with NIHSS or infarct volume. A poor outcome occurred in 32 of 85 patients (37.6%). Among the 50 patients with glutathione measured, 16 had a poor outcome; the ratio was associated with it univariably (odds ratio 2.27 per SD, 95% CI 1.08-4.76) and after age adjustment, but not after adjustment for admission NIHSS (area under the curve 0.72). Conclusions: Acute ischemic stroke was characterized by a coordinated redox imbalance, most pronounced in erythrocyte glutathione homeostasis. The GSSG/GSH ratio was associated with poor 90-day outcome and merits further validation as a prognostic marker.
