Grx2 against H2O2-induced apoptosis is likely associated with its ability to preserve the electron transport chain complex I. In addition to H2O2, Grx2a overexpression is resistant to apoptosis induced by other oxidative stress reagents (i.e., doxorubicin (Dox) and phenylarsine oxide), due to reduced cardiolipin oxidation and subsequent cytochrome c release. Interesting, Grx2 has also been found to prevent aggregation of mutant SOD1 in mitochondria and abolish its toxicity. Being a redox sensor, Grx2 activity is tightly regulated by the oxidative state of the environment via iron-sulfur cluster. In steady state, Grx2 forms dimers to coordinate iron-sulfur clusters, which in turn inactivate Grx2’s activity by sequestering the active-site cysteines. During oxidative stress, the dimers separate into iron-free active monomers, which restore Grx2’s activity. Clinical significance From 42 cases of non-small cell lung cancer patients, the expression level of Grx2 showed a significant correlation with the degree of differentiation in adenocarcinoma and a clear inverse correlation with proliferation. In tumor cells, cells with decreased Grx2 are dramatically sensitized to cell death induced by the anti-cancer drug, DOX. In cardiovascular disease, Grx2a overexpression protects mouse heart from Dox and ischemia-induced cardiac injury, potentially via increasing mitochondrial protein glutathionylation. Conversely, Grx2 knockout hearts developed left ventricular hypertrophy and fibrosis, leading to hypertension. The mechanistic study shows that Grx2 knockout decreased mitochondrial ATP production, possibly via increased glutathionylation and thereby inhibition of complex I. Interactions Grx2 has been shown to physically interact with MDH2, PITPNB, GPX4, CYCS, BAG3, and TXNRD1 in one independent high-throughput proteomic analysis. References Further reading