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Glutathione (GSH) is a highly specialized, endogenous tripeptide natively synthesized in nearly every cell of the human body

For example, patients who are refractory to IMiDs have a higher frequency of cereblon mutations (210%) than untreated patients (0.5%)

[DOI] [PMC free article] [PubMed] [Google Scholar] 206.Pavlov PF

This is complicated because as a polar, charged tripeptide, transport of GSH is significantly inhibited by the blood-brain barrier (BBB), thus limiting effective delivery to brain-resident immune cells such as microglia which are central drivers of neuroinflammatory pathology (Valdovinos-Flores and Gonsebatt, 2012