International Journal of Travel Medicine and Global Health

International Journal of Travel Medicine and Global Health

Glutathione-CRP Inflammatory Index: A Novel Biomarker Differentiating Acute Versus Chronic Inflammation Depth and Clinical Implications via Redox-Immune Pathway Integration

Document Type : Perspective

Authors
1 MD Candidate, Faculty of Medicine, Novosibirsk State University, Russia. B.Sc. in Chemistry, Faculty of Science, Mansoura University, Egypt.
2 The public health department, Riyadh First Health Cluster, Ministry of Health, Saudi Arabia.
10.30491/ijtmgh.2025.546618.1506
Abstract
Background: Chronic inflammation drives pathologies such as prediabetes, type 2 diabetes, colorectal cancer (CRC), severe community-acquired pneumonia (CAP), and liver cirrhosis, yet biomarkers like high-sensitivity C-reactive protein (hsCRP) or interleukin-6 (IL-6) may lack specificity for oxidative-inflammatory depth. We hypothesize that the Glutathione-CRP Inflammatory (GCI) Index, combining hsCRP with the reduced to oxidized glutathione (GSH/GSSG) ratio, could improve diagnostic and prognostic precision. Methods: Archival datasets from prediabetes (n=63), type 2 diabetes (n=50), CRC (n=80), CAP (n=267), and liver cirrhosis (n=75) were analyzed. GCI was calculated as (hsCRP/10 mg/L) + (GSSG/(GSH+GSSG)), normalized to 0–100 using clinical ranges (hsCRP 0–10 mg/L, GSSG/(GSH+GSSG) 0–0.1), and evaluated via logistic regression, receiver operating characteristic (ROC) analysis (hypothesizing 0.05–0.15 AUC improvement), LASSO regularization, and Cox proportional hazards models, adjusting for age, BMI, smoking, and medications. Results: GCI scores might differentiate inflammation types, with values potentially reaching 82 in CRC, 85 in CAP non-survivors, and 80 in Child-Pugh B-C cirrhosis, suggesting associations with tumor progression, mortality, or hepatic decompensation.
In diabetes, scores could decline from 72 to 58 post-GSH supplementation, indicating therapeutic response. GCI may outperform hsCRP (AUC 0.841 vs. 0.780 in CAP) and volatile IL-6, driven by NF-κB-mediated hsCRP elevation and ROS-induced GSH depletion disrupting Nrf2 antioxidant defenses. Conclusion: The GCI Index could enhance chronic disease assessment, pending prospective validation for integration into clinical panels alongside hsCRP or HbA1c.
Keywords


Articles in Press, Accepted Manuscript
Available Online from 11 July 2026

  • Receive Date 12 September 2025
  • Revise Date 05 October 2025
  • Accept Date 05 October 2025