Impact of Sublingual Glutathione on Oxidative Biomarkers and Behavior in Children with Autism: A Pilot Investigation with Pharmacist Involvement

Pharmacy Practice

  • Laila M. Al-Omari1Department of Medical Laboratory Sciences, Al-Ahliyya Amman University, Amman, Jordan.
  • Mohammad A. Beirat2Department of Special Education, Faculty of Educational Sciences, AL-Hussien Bin Talal University, Ma’an.
  • MoezAlIslam E. Faris3Department of Clinical Nutrition and Dietetics, Faculty of Allied Medical Sciences, Applied Science Private University, Amman, Jordan.
  • Abdelrahim A. Hunaiti4Department of Clinical Laboratory Sciences, Faculty of Sciences, The University of Jordan.
  • Yasser Bustanji5College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates; School of Pharmacy, The University of Jordan, Amman 11942, Jordan.

Volume 24 Issue 1 Pages 1-11

DOI: 10.18549/PharmPract.2026.1.3366

Abstract

Background: Autism Spectrum Disorder (ASD) is defined by impairments in social communication, repetitive behaviors, and cognitive variability. Oxidative stress is associated with the pathogenesis of ASD, characterized by imbalances between oxidants and antioxidants, particularly reduced glutathione (GSH). Although glutathione supplementation shows potential, its clinical efficacy remains inconsistent due to limited bioavailability when administered orally. Objectives: This study aimed to assess the impact of sublingual glutathione supplementation on oxidative stress indicators and behavioral outcomes in children diagnosed with ASD. Methods: A total of 25 children with ASD, aged 7 to 18 years, and 25 matched healthy controls participated in an open- label, pre-post intervention trial. The ASD group administered sublingual reduced glutathione for a duration of six weeks. A clinical pharmacist, member of research team, supervised supplement dispensing, provided caregiver counseling, and monitored adherence throughout the study. Serum oxidative stress markers, comprising reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG ratio, total antioxidant capacity (TAC), total oxidant status (TOS), malondialdehyde (MDA), and protein carbonyl levels, were assessed at baseline, three weeks, and six weeks. evaluations utilized the Assessment of Basic Language and Learning Skills-Revised (ABLLS-R). Results: Baseline oxidative stress markers showed elevated stress levels and diminished antioxidant capacity in patients with ASD compared to controls (p < 0.05). Following the intervention, notable improvements in antioxidant status, as measured by GSH, the GSH/GSSG ratio, and TAC, were observed. Behavioral improvements were significant in specific domains, including cooperation, imitation, social interaction, visual performance, vocal imitation, play, and receptive language. Conclusions: Sublingual glutathione supplementation significantly elevated antioxidant levels and specifically improved behavioral functioning in children with ASD. Pharmacist involvement contributed to proper administration and adherence, supporting the effective delivery of the intervention. These data indicate the possible usefulness of antioxidant therapy in the management of oxidative stress-related symptoms in ASD. Additional randomized controlled trials are advised.

Keywords

  • Autism Spectrum Disorder (ASD)
  • Sublingual glutathione
  • Oxidative stress
  • Antioxidant markers
  • Behavioral outcomes
  • Autism Glutathione
  • supplementation
Pharmacy Practice

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