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GSH regeneration is catalyzed by glutathione reductase using GSSG and NADPH generated by the pentose phosphate pathway (PPP, also called hexose monophosphate shunt, which also produces pentose phosphate sugars used in nucleotide synthesis.) The first reaction of the PPP, catalyzed by glucose 6-phosphate dehydrogenase (G6PD), is critical for producing an adequate amount of NADPH used in reductive biosynthetic pathways and importantly in the generation of GSH
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As a complex disease involving multiple factors and genetic interactions, the etiology and pathogenesis of IBD remain unclear, but it is generally believed to be associated with environmental factors, genetic susceptibility, gut microbiota, and immune responses [260]
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