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Cold Spring Harb Perspect Biol · 2021

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Chandel NS

NADPH-The Forgotten Reducing Equivalent

13(6).

DOI PMID: 34074675 Open original source
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Educational review
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Full text reviewed

Cellular protection from reactive oxygen involves more than simply eliminating every reactive molecule. This paper explains the role of NADPH, a molecule that supplies electrons for building cellular materials and controlling reactions involving oxygen. NADPH helps restore protective systems such as glutathione, but also powers enzymes that deliberately produce reactive oxygen molecules for useful functions. The paper highlights the importance of this balance through G6PD deficiency, an inherited enzyme disorder it estimates affects about 400 million people worldwide. Red blood cells with this deficiency have less capacity to withstand certain forms of oxidative stress.

The same broad category of molecules can participate in normal signalling or cause damage, depending on amount, location, and chemical type. Hydrogen peroxide at controlled levels can temporarily alter proteins and transmit signals. Higher or poorly controlled exposure can damage cellular components. NADPH therefore supports a regulated system rather than functioning as a simple switch that turns all oxidation off.

How Does This Show Up in Real Life?

This distinction matters when an antioxidant claim suggests that removing more reactive oxygen must always improve health. Cells use some of these molecules to communicate and respond to stress, and immune cells use them in defence against bacteria. The paper also offers a concrete example of why individual biology matters: certain infections, drugs, or fava-bean exposure can trigger red blood cell damage in susceptible people with G6PD deficiency. That does not mean fava beans have the same effect in everyone. More broadly, the presence of oxidative damage in a disease does not show that taking an antioxidant will treat its cause. The article explains these mechanisms and questions; it does not test a supplement regimen or provide a method for readers to adjust their own NADPH levels.

The author notes major measurement difficulties: tools do not always distinguish different reactive oxygen molecules or their locations inside cells accurately. It can also be unclear whether increased oxidation causes disease or follows it. Clinical antioxidant studies discussed have not consistently translated biological explanations into benefit, and some reported harm. The paper does not establish a single explanation for those differing outcomes.

Use this source to understand why a molecule can have both protective and signalling roles without contradiction. Its value lies in the distinctions between chemical activity, normal physiology, and disease. A convincing mechanism still needs appropriate clinical evidence before supporting a health claim.

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