Elevated plasma homocysteine concentration in humans is associated with increased risk of arteriosclerosis and ischaemic heart disease. We studied whether the plasma homocysteine concentration could be changed by administration of drugs that modulate the concentration of glutathione in both plasma and tissue. Male wistar rats received reduced glutathione (0.5 mmol/kg), N-acetylcysteine (0.5 mmol/kg), L-buthionine-[S,R]-sulfoximine (2 mmol/kg) or Ringer acetate intravenously. Twenty min. later an arterial blood sample was drawn for the measurement of homocysteine and other thiols in the plasma. The thiols were quantified by reversed-phase ion-pair liquid chromatography and fluorescence detection. The total homocysteine concentration in plasma of fasted rats was 6.1∫0.5 mM. Intravenous administration of reduced glutathione or N-acetylcysteine reduced the homocysteine concentration in plasma significantly by 51% to 3.0∫0.3 mM and 63% to 2.2∫0.2 mM, respectively (PϽ0.05). In contrast, L-buthionine-[S,R]-sulfoximine increased the concentration of homocysteine by 41% to 8.6∫0.6 mM (PϽ0.05). The glutathione concentration in plasma was 19.5∫1.9 mM in controls and was unchanged by N-acetylcysteine administration. Reduced glutathione increased plasma glutathione to 379.7∫22.9 mM (PϽ0.05), whereas L-buthionine-[S R]-sulfoximine lowered the plasma glutathione concentration to 5.3∫0.4 mM. Homocysteine was negatively correlated to the glutathione (rΩª0.399, PϽ0.01) and the cysteine (rΩª0.52, PϽ0.01) concentrations in plasma. Our conclusion is that modulation of the glutathione levels influences the concentration of homocysteine in plasma of rats.An elevated concentration of homocysteine in plasma constitutes an independent risk of vascular disease (Graham et al. 1997;Robinson et al. 1998). It seems clear that homocysteine damages venous and arterial endothelial cells, which is probably related to the production of hydrogen peroxide during oxidation of homocysteine to homocystine. The cellular damage can be prevented by catalase (Wilcken & Dudman 1989). Homocysteine also has mitogenic properties on vascular smooth muscle cells and reduces the cell proliferation of the endothelium (Tsai et al. 1994). However, the mechanisms by which homocysteine induces atherosclerotic disease, are not fully clarified.Factors that influence the plasma homocysteine level are therefore of interest for chemoprevention of atherosclerotic heart disease. Folic acid, vitamin B 6 and B 12 , alone or in combination, lower the plasma level of homocysteine both among patients with a pathologically high plasma homocysteine level (Lobo et al. 1999) and in persons with plasma homocysteine levels within normal range (Dierkes et al. 1998).N-acetylcysteine lowers the plasma level of homocysteine also in patients with a high level of lipoprotein (a) (Wiklund et al. 1996) and in healthy volunteers (Hultberg et al. 1994). N-Acetylcysteine is often used clinically as a safe substrate Author for correspondence: Kjell K. Øvrebø, Surgical Research Laborator...