NRF2, a transcription factor associated with the cellular response to oxidative stress, has been found to be indirectly regulated by O-GlcNAc. KEAP1, an adaptor protein for the cullin 3-dependent E3 ubiquitin ligase complex, mediates the degradation of NRF2; oxidative stress leads to conformational changes in KEAP1 that repress degradation of NRF2. O-GlcNAc modification of KEAP1 at S104 is required for efficient ubiquitination and subsequent degradation of NRF2, linking O-GlcNAc to oxidative stress. Glucose deprivation leads to a reduction in O-GlcNAc and reduces NRF2 degradation. Cells expressing a KEAP1 S104A mutant are resistant to erastin-induced ferroptosis, consistent with higher NRF2 levels upon removal of S104 O-GlcNAc.
Elevated O-GlcNAc levels have been associated with diminished synthesis of hepatic glutathione, an important cellular antioxidant. Acetaminophen overdose leads to accumulation of the strongly oxidizing metabolite NAPQI in the liver, which is detoxified by glutathione. In mice, OGT knockout has a protective effect against acetaminophen-induced liver injury, while OGA inhibition with thiamet-G exacerbates acetaminophen-induced liver injury.