G6PD deficiency - mechanism (NADPH and glutathione regeneration)
Core concept
- G6PD = rate-limiting enzyme of the pentose phosphate pathway, generates NADPH
- NADPH regenerates reduced glutathione (GSH) -> GSH neutralises oxidative stress (H2O2) in the red cell
- G6PD deficiency -> dec NADPH -> dec GSH regeneration -> RBCs cannot buffer oxidative stress -> haemoglobin denatures (Heinz bodies) and membrane damages -> haemolysis specifically under oxidative challenge
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