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Enzyme Mediated S- glutathionylationgenomics.unl.edu/RBC_2019/COURSE_FILES/tue4.pdf · 2019. 6....

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Enzyme Mediated S- glutathionylation Danyelle M. Townsend Director, Analytical Redox Biochemistry Nebraska, June 11, 2019
Transcript
  • Enzyme Mediated S-

    glutathionylation

    Danyelle M. Townsend Director,

    Analytical Redox Biochemistry

    Nebraska, June 11, 2019

  • www.creative-proteomics.com

    Post-translational modifications:

    Highly Regulated Complexity of Life

  • # cysteinesin genome

    Biological complexity 200,000 cysteines in human proteome

    Possible Cysteine Post translational modifications:

    • thiol/disulfide, thiolate, sulfenate, sulfinate, sulfonate

    • S-glutathionylation

    • S-nitrosylation

    • S-cysteinylation

    • S-sulfydration (persulfide)

    • S-thiohemiacetylation

    • S-succinylation

    • S-isoprenylation

    • S-farnesylation

    • S-geranylgeranylation

    • S-palmitoylation

    Cysteine: Post-translational Modifications

    From: Tew et al, 2016

  • # cysteines in genome

    Biological complexity

    200,000 cysteines in human proteome

    https://www.researchgate.net/publication/232226611_Oxidative_Modification_of_Proteins_An_Emerging_Mechanism_of_Cell_Signaling

  • H2N

    CH2

    COOH

    SH

    H2N

    CH2

    COOH

    S

    S

    HN

    O

    COOHNH

    O

    COOH

    NH2

    Low pK

    cysteine

    residue

    S-glutathionylation

    Deglutathionylation

    H2N

    CH2

    COOH

    S

    OH

    O O

    H2N

    CH2

    COOH

    S

    OH

    O

    H2N

    CH2

    COOH

    S

    OH

    H2N

    CH2

    COOH

    S.

    Cysteinyl radical Sulfinic acid Sulfonic acidSulfenic acid

    [O]

    [N]

    S-Glutathionylation

    Protected

    Glutaredoxin

    GSTO

    Sulfiredoxin

    GST

    OxidationReduction

    degrade

  • Gstp1/p2-/- mice

    HPC : hematopoietic progenitor cells

    `✓

    GSTP knockout mice

  • 0 15 30 60 120 240 min0 5 10 15 20 25 uM250

    75

    50

    30

    250

    75

    50

    30

    GST-WT

    GST-KO

    PABA/NO PABA/NO 15 uM

    Enhanced S-glutathionylation in GST WT- MEFs

  • GST-WT

    0 15 30 60 120 240 (min)

    IB: Actin

    0 50 100 200 300 500 uM

    IB: PSSG GST-KO

    NOV-002 NOV-002 (100 uM)

    IB: PSSG

    Townsend et al., 2009, JBC

    Enhanced S-glutathionylation in GST-WT MEFs

  • S-glutathionylation of actin alters focal contacts

  • Increased S-glutathionylation in GST WT mice

  • GSTP: cys 47 & 101 are

    S-glutathionylated

    From: Townsend et al, JBC: 284, 436-445, 2009

  • APOPTOSIS PROLIFERATION

    Enzyme mediated S-glutathionylation

    P

    JNK

    c-jun

    GSTπ

    P

    S-glutathionylated

    oligomer

    c-jun

    JNK

    c-jun

    GSTπ

    GSTπ

    Townsend, D.M. 2007 Molecular Intervention

    Townsend and Tew. 2012 ARS

    s

    Energy MetabolismSignaling Pathways

    Calcium

    homeostasis

    GSTP is auto-regulated by

    (trans) S-glutathionylation

  • GSTP S-glutathionylates ER resident proteins

    Mass Spectrometry Identification of S-glutathionylated ER proteins

    Protein ID MW (kDa)

    Calnexin 97

    Calreticulin 60

    Endoplasmin 94

    SERCA2A 114

    GRP78, Bip 78

    Protein disulfide isomerase (A5) 59

  • GSTP interacts with ER protein

    and enhances S-glutathionylation

    GSTP

    BIP

    PDI

    GSTP

    Calnexin

    GSTP

    Calreticulin

    GSTP

    IP: Calnexin

    IP: BIP

    IP: Calreticulin

    IP: PDI

    Total IP IP IgG

    Disulfiram

    (10µM)

    - - + -

    Gstp1/p2+/+

    Gstp1/p2-/-

  • How does cytosolic GSTP

    catalyze S-glutathionylation of

    Endoplasmic Reticulum resident

    proteins?

  • GSTP

    Calnexin

    GAPDH

    Gstp1/p2 + - + - + -

    ER Cyto Nuc

    Histone H3

    SERCA2

    GSTP is a resident ER Protein

  • GSTP is a resident Endoplasmic

    Reticulum (ER) protein

    BIP GSTP Merge - TRIODAPI - nuclear

    CalnexinDAPI - nuclear GSTP Merge - TRIO

  • GSTP regulates ER Calcium homeostasis

    0%

    20%

    40%

    60%

    80%

    100%

    120%

    0 500 1000 1500

    ER

    Calc

    ium

    ho

    meo

    sta

    sis

    (% o

    f co

    ntr

    ol)

    Time (second)

    Gstp1/p2+/+Gstp1/p2-/-

    Thapsigargin Gstp1/p2+/+

    Gstp1/p2-/-

  • Thapsigargin

    (nM)

    Velcade

    (nM)

    Gstp1/p2+/+ 121.7 23.6

    Gstp1/p2-/- 16.5 3.0

    ratio 7.4 7.9

    Thapsigargin and Velcade are more toxic to

    Gstp1/p2-/- BMDDCs

    Viability (IC50 value)

  • Endoplasmic Reticulum (ER)Albert Claude 1945

    Lace work structure”

    Rough ER

    • Protein synthesis: Secreted, membrane bound, digestive enzymes, hormones and antibodies

    • Translocon docking sites for ribosome

    • GSH/ GSSG ~10:1

    Smooth ER:

    • Lipid / phospholipid and steroid synthesis

    • Calcium ion storage

    Sarcoplasmic ER:

    Calcium storage: major role in excitation / contraction coupling

  • Demand exceeds capacity ……..

  • Conditions Probable effects

    temperature shifts

    (e.g., heat-shock)

    protein denaturation

    protein aggregation

    heavy metals, arsenite,

    iodoacetamide

    reaction with sulfhydryl goups,

    conformational changes in protein

    anoxia, hydrogen peroxide,

    superoxide ions, free radicals

    oxygen toxicity, free radical

    fragmentation of proteins

    proteasome inhibitors inhibition of proteolysis

    amytal, azide, dinitrophenol,

    ionophores

    antimycin

    inhibition of oxidative phosphorylation,

    changes in redox state,

    covalent modification of proteins

    hydroxylamine cleavage of asparagine-glycine bonds

    ethanol translation errors

    amino acid analogs, puromycin abnormal proteins

    Agents/Treatments that induce ER stress response

  • Grek and Townsend (2013): ER stress and Cancer Biology:

  • Gstp1/p2-/- mice

    HPC : hematopoietic progenitor cells

    `✓

    GSTP knockout mice

  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375108/

    ER dysfunction in liver disease

  • Toxicology of Acetaminophen

    Journal of Clinical and Translational Hepatology 2016;4(2):131-142

  • Increased resistance to acetaminophen hepatotoxicity

    in mice lacking glutathione S-transferase PiColin J. Henderson*, C. Roland Wolf* Neil Kitteringham,Helen Powell §, Diana Otto*, and B. Kevin Park

    NAPQI + GSH Detox (NOT related to GSTP)

    NAPQI + Protein adduct equivalent

    GSTP +/+ decreased GSH/GSSG

    ** Toxic role of GSTP downstream of protein conjugation of NADPQI

  • J Pharmacol Exp Ther. 2013 Jan;344(1):286-94. doi: 10.1124/jpet.112.199067. Epub 2012 Oct 23.

    Mouse liver protein sulfhydryl depletion after acetaminophen exposure.Yang X, Greenhaw J, Shi Q, Roberts DW, Hinson JA, Muskhelishvili L, Davis K, Salminen WF.

    Source

    Division of Systems Biology, National Center for Toxicological Research, Jefferson, Arkansas, USA.

    Protein – SH depleted regions correlated with areas exhibiting histopathologic injury

    NOT GLOBAL DECREASE IN LIVER

    http://www.ncbi.nlm.nih.gov/pubmed/23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Yang X[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Greenhaw J[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Shi Q[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Roberts DW[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Hinson JA[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Muskhelishvili L[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Davis K[Author]&cauthor=true&cauthor_uid=23093024http://www.ncbi.nlm.nih.gov/pubmed?term=Salminen WF[Author]&cauthor=true&cauthor_uid=23093024

  • J Pharmacol Exp Ther. 2012 Feb;340(2):360-8. doi: 10.1124/jpet.111.187948. Epub 2011 Nov 1.

    Changes in mouse liver protein glutathionylation after

    acetaminophen exposure.Yang X, Greenhaw J, Ali A, Shi Q, Roberts DW, Hinson JA, Muskhelishvili L, Beger

    R, Pence LM, Ando Y, Sun J, Davis K, Salminen WF.

    1h = Increased P-SSG

    24h = Decreased P-SSG at site of necrosis

    PROTEIN OXIDATION 10x > APAP-Conjugation

  • Zhang, K. et al. J. Biol. Chem. 2004

    Three UPR transducers and one master regulator

    GRP78 / BiP: Glucose related protein / Binding Immunoglobin Protein

  • Decreased S-glutathionylation of

    BiP in GSTP1P2 knockout mouse

    liver

    GSTp

    GAPDH

    BiP

  • 112213_SCW_II_141_Glut_BIP_FirstZT #16877 RT: 94.18 AV: 1 NL: 1.91E4F: ITMS + c NSI d Full ms2 [email protected] [220.00-1710.00]

    300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700

    m/z

    0

    5

    10

    15

    20

    25

    30

    35

    40

    45

    50

    55

    60

    65

    70

    75

    80

    85

    90

    95

    100

    Re

    lative

    Ab

    un

    da

    nce

    x5 x5

    34DLGTTYSC(glut)VGVFK46MH+ = 1694.74 Da

    M+2H+ = 847.87 Da

    y2294.16

    y4450.23

    b5-H2O

    470.22

    b4387.23

    y5549.34

    (y11-129)2+

    669.46

    y112+

    733.98

    y3393.26

    (M+2H-129-H2O)2+

    774.56

    (M+2H-129)2+

    783.53

    y6-129-H2O

    810.65

    (M+2H-H2O-NH3)2+

    829.60

    y7-129

    915.44

    y6957.50

    y71044.46

    y8-129

    1078.50

    y81207.56

    y9-129

    1179.58

    y91308.57

    b91245.51

    b11-129

    1272.50

    y11-129

    1337.61

    b111401.63

    y111466.72

    b121548.49

    b9-129

    1116.51

    BiP is s-glutathionylated on C41 and C420

    BiP

    PSS

    G

    Merge

  • HEPG2 Cells pre-treated with NAC (and

    treated with 15mM APAP for 16hrs) have

    28% increase in GSH

    RESULTS:

    0

    20

    40

    60

    80

    100

    120

    140

    160

    Relative GSH concentration

    **

  • BiP-SSG is concurrent with APAP

    induced liver toxicity

    • BiP: GSTpi dissociates when under ER stress

    • GSTpi KO mice have 42% less SSG-BiP than GSTpi WT mice

    • NAC treatment increases GSH / decreases BiP-SSG and reduces apoptosis

  • S-glutathionylation of BiP

    attributes to multiple

    myeloma resistance

  • Anti GSHCell lysate IP: IgG IP: BiP

    MS MR US URMS MR US URMS MR US UR

    MM resistant cells have higher S-glutationylated levels of BiP.

    112213_SCW_II_141_Glut_BIP_FirstZT #16877 RT: 94.18 AV: 1 NL: 1.91E4F: ITMS + c NSI d Full ms2 [email protected] [220.00-1710.00]

    300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700

    m/z

    0

    5

    10

    15

    20

    25

    30

    35

    40

    45

    50

    55

    60

    65

    70

    75

    80

    85

    90

    95

    100

    Rel

    ativ

    e Ab

    unda

    nce

    x5 x5

    34DLGTTYSC(glut)VGVFK46

    MH+ = 1694.74 Da

    M+2H+ = 847.87 Da

    y2294.16

    y4450.23

    b5-H2O

    470.22

    b4387.23

    y5549.34

    (y11-129)2+

    669.46

    y112+

    733.98

    y3393.26

    (M+2H-129-H2O)2+

    774.56

    (M+2H-129)2+

    783.53

    y6-129-H2O

    810.65

    (M+2H-H2O-NH3)2+

    829.60

    y7-129

    915.44

    y6957.50

    y71044.46

    y8-129

    1078.50

    y81207.56

    y9-129

    1179.58

    y91308.57

    b91245.51

    b11-129

    1272.50

    y11-129

    1337.61

    b111401.63

    y111466.72 b12

    1548.49

    b9-129

    1116.51

    112213_SCW_II_141_Glut_BIP_FirstZT #24932 RT: 130.02 AV: 1 NL: 5.13E4F: ITMS + c NSI d Full ms2 [email protected] [185.00-2000.00]

    200 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 1800 1900 2000

    m/z

    0

    5

    10

    15

    20

    25

    30

    35

    40

    45

    50

    55

    60

    65

    70

    75

    80

    85

    90

    95

    100

    Relat

    ive A

    bund

    ance

    x5

    418DVC(glut)PLTLGIETVGGVMTK435

    MH+ = 2138.02 Da

    M+3H+ = 713.34 Da

    y2248.25

    y3379.35

    y5535.35

    y6592.33

    (M+3H-129-H2O)3+

    664.50

    or

    b102+-H2O

    b92+

    609.62

    b3623.34

    y4478.46

    b32+

    312.31

    b3-129

    494.34

    b111447.93

    b91217.47

    b81104.47

    b71047.59

    b172+

    996.

    74

    b162+

    945.

    94

    b152+

    880.

    65

    b122+

    774.

    14

    or

    y8-

    H2O

    y9921.58

    (M+3H-H2O-NH3)3+

    701.65 b142+

    831.

    15

    y8792.

    49b13

    2+

    802.

    39

    y7691.55

    Wavelength, nm

    180 200 220 240 260 280

    Mo

    lecu

    lar E

    llip

    ticit

    y,

    -40000

    -30000

    -20000

    -10000

    0

    10000

    20000

    BIP

    BIP-SSG

    CD Analysis

    Wavelength, nm

    300 320 340 360 380 400 420 440 460

    Em

    issio

    n,

    co

    un

    ts/s

    ec

    0.0

    2.0e+4

    4.0e+4

    6.0e+4

    8.0e+4

    1.0e+5

    1.2e+5

    1.4e+5

    BIP

    GSS-BIP

    Tryptophanyl Fluorescence

    0

    50

    100

    150

    200

    BiP BiP-SSG

    AT

    Pas

    e ac

    tivit

    y (

    %)

    0

    50

    100

    150

    200

    BiP BiP-SSGH

    old

    ase

    acti

    vit

    y (

    %)

    BiP

    GSH

    Merge

    Disulfiram - +

  • S

    S+TLK1

    99 R

    R+TLK1

    99

    U266 5.4 3.2 27.5 10.1

    MM1.s 5.3 4.1 26.5 9.8

    S: BTZ sensitive MM cells; R: BTZ resistant MM cells

    Table 1. Cross resistance

    IC50 (fold resistance)MM1s.S MM1s.R U266 U266R

    BTZ (nM) 5.4 27.5 (~5) 5.3 26.5 (~5)

    ThG (nM) 8 18 (~2) 6 35 (~6)

    TuM

    (ng/mL)

    13 43 (~3) 12 43 (~3.5)

    Table 2. IC50 values of BTZ (nM)

    Proteosome Resistance in Multiple Myeloma Confers

    Collateral Resistance to ER Stress Inducers

  • SO

    D2

    GS

    TP

    Grx

    1

    Prx

    6

    Trx

    1

    Trx

    2

    Srx

    GPx

    1/2

    Prx5

    Prx2

    GPx

    4

    PDI

    S R S R

    MM1s U266

    S R S R

    MM1s U266

    UPR proteins Redox enzyme

    IRE1

    BiP

    GRP94

    GAPDH

    S R S R

    MM1s U266

    GR

    MM resistant cells have different expression of UPR proteins and

    redox enzymes

    0

    0.5

    1

    1.5

    2

    2.5

    3

    3.5

    Pro

    tein

    ex

    pre

    ssio

    n

    (rel

    ativ

    e to

    sen

    siti

    ve

    cell

    s)

    UPR and Redox enzyme profile

    MM1s S MM1s R U266 S U 266 R

  • CHOP

    ATF4

    Actin

    0 6 18 24 0 6 18 24

    hrs

    Btz (5 nM)

    Control Telintra

    MM1.S

    1 1.1 2.4 3.3 0.9 1.1 2.3

    3.4

    1 1.0 1.4 1.1 0.7 1.3 3.6

    2.1

    Telintra reverses resistance to Velcade (Btz) in

    multiple myeloma.

    NH

    ONH

    SO

    Telintra

    COOC2H5

    COOC2H5H2N

    0

    0.2

    0.4

    0.6

    0.8

    1

    1.2

    0.001 0.01 0.1 1 10 100 1000

    Cellviab

    ility(relativetoControl)

    Btz (nM)

    Multiplemyeloma Sensitive

    Sensitive+TLK

    BtzResistant

    BtzResistant+TLK

  • Unfolded and misfolded proteins magically appear?

  • 125

    100

    75

    50

    25

    0

    0 20 40 60

    Perc

    en

    tS

    urv

    ival

    µM PABA/NO µM PABA/NO0 5 15 25 40

    NO

    Gen

    era

    tio

    n

    F

    old

    I

    ncrease

    50

    40

    30

    20

    10

    PABA/NO induced NO generation is

    concurrent with P-SSG and apoptosis

    Townsend et al., Cancer Research, 2009

  • • Β-lactate

    dehydrogenase• Rho GDP

    Dissociation inhibitor

    • Nucleophosmin

    • Protein Disulfide

    Isomerase

    • ATP synthase

    • Chaperonin / HS65

    • Glucosidase

    • Elongation factor II

    Untreated 30μM PABA/NO

    Coomassie: topα-Glutathionylation: bottom

    Townsend et al., Mol. Pharm. 2006

    2D – SDSMALDI-TOFIdentification of S-glutathionylated

    proteins

  • Protein Disulfide Isomerase

    • 55 kDa Homodimer

    • 14 PDI isoforms in ER

    • Two – UPRE in promotor– (Kox = 1mM)

    • Widely distributed across eukaryoticTtiainsest aul., 2e00s6:Cell: 14(1): 61-73– mM Concentrations

    – 1% total pr. Content of cells

    – Decreased PDI leads to protein aggregation (ie Anti-chaperone)

  • Disulfide Formatio

    nSH SH

    Sulfydryl

    S-SSH SH

    PDI

    PDI

    Disulfide

    Disulfide

    Isomerizations

    SH SH

    PDI

  • PABA/NO

    IP:α-PDI

    IP:IgG

    DTT

    - - + + +

    + - - + +

    - + + - -

    - - - - +

    250

    105

    75

    50

    WB:PSSG

    WB:PDI

    PDI-SSG is concurrent with UPR activation

  • PDI

    PABA/NO

    GSH

    + + +

    +

    -

    -

    +

    +

    +

    Mr (kDa)

    75

    50

    WB: PSSG

    WB: P-SNO

    WB: PDI

    75

    50

    75

    50

    Active Site Cysteine Residues Are

    Molecular Targets of PABA/NO

  • PDI-SSG Alters Structure / Function

    120

    100

    80

    60

    40

    20

    0

    Per

    cen

    tAct

    ivit

    y

    0 25 50 100

    μM PABA/NO

    250 300 350 400

    Wavelength, nm

    450 500 550

    -20

    0

    20

    40

    60

    100

    80 GSTSG

    GST Intact

    200 220 240

    Wavelength,nm

    260 280

    -40

    180

    -20

    0

    20

    40

    60

    80 120

    GSTINTACT

    GSTSG

    Circular Dichroism Intrinsic Fluorescence

    C47

    W38

  • Generation of S-glutathionylation

    refractory PDI (conversion of basic a.a.

    adjacent to catalytic cysteines to neutral)WCGHCK

    a domain

    WCGHCK

    a’domain

    PDI-WT

    WCGFCL WCGFCLPDI-FLFL

    Histidine (H)

    Lysine (K)

    Phenylalanine

    (F)

    Leucine

    (L)

    Alanine

    (A)

  • PDIFLFL is refractory to S-glutathionylation

    WB: P-SSG

    WB: PDI

    In Vitro PDIWT

    0 25 50

    PABA/NO

    PDIFLFL

    100 0 25 50 100

    PDIWT PDIFLFL

    - + - +

    Rotenone

    FLAG-

    PDIWT

    - +

    FLAG-PDIFLFL

    - + PABA/NO+

    In Cells

    Ctr

    IP: FLAG

    WB: PDI-

    PSSGWB: PDI

    WB: P-SSG

    WB: PDI

    500 1000 Rotenone(µM)0 100 250

  • Rotenone (uM)

    Mean

    O.D

    .

    0

    2

    4

    6

    0

    5

    10

    0

    2

    4

    PD

    I

    mR

    NA

    fold

    incre

    ase

    - + -

    +PDIWT PDIFLFL

    - + -

    +PDIWT PDIFLFL

    - + - +PDIWT PDIFLFL

    BIP

    mR

    NA

    fold

    incre

    ase

    CH

    OP

    mR

    NA

    fold

    incre

    ase

    S-glutathionylation

    refractory PDI1) Blunts the toxic effects of rotenone

    2) Diminishes activation of the UPR in

    PC12 neuronal cells

  • PDI is a chaperone for ER

    What are the consequences of S-

    glutahtionylation of PDI on ER stability and

    transcriptional activation?

  • PDI: Chaperone for Estrogen Receptor alpha

    Xiong, Y et al, Int J Cell Biol. 2012

  • PSSG

    PDI

    PABA/NO (h) 0 0.5 2

    75

    50

    75

    50

    IP: PDI

    75

    50

    0 0.5PABA/NO (h) 2

    IP: ER

    PDI

    ER

    75

    50

    PDI-SSG blunts chaperone activity with

    ERα

    Xiong et al., 2011. IJCB

  • A

    PDI FLAG

    BPDI OEVector

    ER

    PABA/NO (h)0 4 8

    PDI

    Actin

    0 4 8

    Xiong, Y et al, Int J Cell Biol. 2012

    120

    100

    80

    60

    40

    20

    0

    PDI level affects PABA/NO-stimulated ER degradation

  • E2 (20 nM)

    0 2 4 8 (h)

    ER

    ER

    c-Myccyclin D1

    p21WAF1/CIP1

    Actin

    PABA/NO (20 M)

    0 2 4 8 (h)

    ER

    ERcyclin D1

    p21WAF1/CIP1

    Actin

    Cyclin D1 mRNA and protein were down-regulated by anti-estrogen ICI182780

    (Faslodex). ICI182780 also increased the expression of the CDK inhibitor p21WAF1/

    CIP1 (Watts CK, et al. 1995)

    PDI-SSG has anti-estrogen effects

  • Grek, C and Townsend, D.M. (2013)

  • ER stress is worth stressing over…

    Parkinson’s

    A

    G

    E

    Huntington’s

    Alzheimer's

    Heart Disease

    ER stress has been linked to the following medical conditions:

  • Conclusions

    GSTP catalyzes the forward reaction of S-

    glutathionylation toward a large number of

    proteins

    GSTP is an ER resident protein (high levels).

    GSTP forms protein interactions with ER resident

    proteins important in regulating the UPR

    GSTP protects from ER stress agents, including

    Velcade, and has a role in cancer drug resistance.


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