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Gamma-glutamyl transpeptidase
Available protein structures:
Pfam  structures / ECOD  
PDBsumstructure summary
EC no.
CAS no.9046-27-9
IntEnzIntEnz view
ExPASyNiceZyme view
MetaCycmetabolic pathway
PDB structuresRCSB PDB PDBe PDBsum
Gene OntologyAmiGO / QuickGO
gamma-glutamyltransferase 1
Alt. symbolsGGT
NCBI gene2678
Other data
EC number2.3.2.2
LocusChr. 22 q11.1-11.2
Search for
gamma-glutamyltransferase 2
Alt. symbolsGGT
NCBI gene2679
Other data
EC number2.3.2.2
LocusChr. 22 q11.1-11.2
Search for

Gamma-glutamyltransferase (also γ-glutamyltransferase, GGT, gamma-GT, gamma-glutamyl transpeptidase;[1] EC is a transferase (a type of enzyme) that catalyzes the transfer of gamma-glutamyl functional groups from molecules such as glutathione to an acceptor that may be an amino acid, a peptide or water (forming glutamate).[1][2]: 268  GGT plays a key role in the gamma-glutamyl cycle, a pathway for the synthesis and degradation of glutathione as well as drug and xenobiotic detoxification.[3] Other lines of evidence indicate that GGT can also exert a pro-oxidant role, with regulatory effects at various levels in cellular signal transduction and cellular pathophysiology.[4] This transferase is found in many tissues, the most notable one being the liver, and has significance in medicine as a diagnostic marker.


The name γ-glutamyltransferase is preferred by the Nomenclature Committee of the International Union of Biochemistry and Molecular Biology.[5][2] The Expert Panel on Enzymes of the International Federation of Clinical Chemistry also used this name.[6][2] The older name is gamma-glutamyl transpeptidase (GGTP).[2]


GGT is present in the cell membranes of many tissues, including the kidneys, bile duct, pancreas, gallbladder, spleen, heart, brain, and seminal vesicles.[7] It is involved in the transfer of amino acids across the cellular membrane[8] and leukotriene metabolism.[9] It is also involved in glutathione metabolism by transferring the glutamyl moiety to a variety of acceptor molecules including water, certain L-amino acids, and peptides, leaving the cysteine product to preserve intracellular homeostasis of oxidative stress.[10][11] This general reaction is:

(5-L-glutamyl)-peptide + an amino acid ⇌ peptide + 5-L-glutamyl amino acid


In prokaryotes and eukaryotes, GGT consists of two polypeptide chains, a heavy and a light subunit, processed from a single chain precursor by an autocatalytic cleavage.[12] The active site of GGT is known to be located in the light subunit.[citation needed]

Co-translational N-glycosylation serves a significant role in the proper autocatalytic cleavage and proper folding of GGT. Single site mutations at asparagine residues were shown to result in a functionally active yet slightly less thermally stable version of the enzyme in vitro, while knockout of all asparagine residues resulted in an accumulation of the uncleaved, propeptide form of the enzyme.[12]

Clinical significance[edit]

GGT is predominantly used as a diagnostic marker for liver disease.[citation needed] Elevated serum GGT activity can be found in diseases of the liver, biliary system, pancreas and kidneys.[13][14] Latent elevations in GGT are typically seen in patients with chronic viral hepatitis infections often taking 12 months or more to present.[citation needed]

Individual test results should always be interpreted using the reference range from the laboratory that performed the test, though example reference ranges are 15–85 IU/L for men, and 5–55 IU/L for women.[15] GGT is similar to alkaline phosphatase (ALP) in detecting disease of the biliary tract. Indeed, the two markers correlate well, though there are conflicting data about whether GGT has better sensitivity.[16][17] In general, ALP is still the first test for biliary disease. The main value of GGT is in verifying that ALP elevations are, in fact, due to biliary disease; ALP can also be increased in certain bone diseases, but GGT is not.[17]

Alcohol use[edit]

GGT is elevated by ingestion of large quantities of alcohol (needs reference) However, determination of high levels of total serum GGT activity is not specific to alcohol intoxication,[18] and the measurement of selected serum forms of the enzyme offer more specific information.[19] Isolated elevation or disproportionate elevation compared to other liver enzymes (such as ALT or alanine transaminase) can indicate harmful alcohol use or alcoholic liver disease,[20] and can indicate excess alcohol consumption up to 3 or 4 weeks prior to the test.[citation needed] The mechanism for this elevation is unclear. Alcohol might increase GGT production by inducing hepatic microsomal production, or it might cause the leakage of GGT from hepatocytes.[21]


Numerous drugs can raise GGT levels, including barbiturates and phenytoin.[22] GGT elevation has also been occasionally reported following nonsteroidal anti-inflammatory drugs (including aspirin), St. John's wort and kava.[23]

Cardiovascular disease[edit]

More recently, slightly elevated serum GGT has also been found to correlate with cardiovascular diseases and is under active investigation as a cardiovascular risk marker. GGT in fact accumulates in atherosclerotic plaques,[24] suggesting a potential role in pathogenesis of cardiovascular diseases,[25] and circulates in blood in the form of distinct protein aggregates,[19] some of which appear to be related to specific pathologies such as metabolic syndrome, alcohol addiction and chronic liver disease.

Elevated levels of GGT can also be due to congestive heart failure.[26]


GGT is expressed in high levels in many different tumors. It is known to accelerate tumor growth and to increase resistance to cisplatin in tumors.[27]


Human proteins that belong to this family include GGT1, GGT2, GGT6, GGTL3, GGTL4, GGTLA1 and GGTLA4.


  1. ^ a b Tate SS, Meister A (1985). "[50] γ-Glutamyl transpeptidase from kidney". gamma-Glutamyl transpeptidase from kidney. Methods in Enzymology. Vol. 113. pp. 400–19. doi:10.1016/S0076-6879(85)13053-3. ISBN 978-0-12-182013-8. PMID 2868390.
  2. ^ a b c d Whitfield JB (August 2001). "Gamma glutamyl transferase". Critical Reviews in Clinical Laboratory Sciences. 38 (4): 263–355. doi:10.1080/20014091084227. PMID 11563810. S2CID 1070555.
  3. ^ Courtay C, Oster T, Michelet F, Visvikis A, Diederich M, Wellman M, Siest G (June 1992). "Gamma-glutamyltransferase: nucleotide sequence of the human pancreatic cDNA. Evidence for a ubiquitous gamma-glutamyltransferase polypeptide in human tissues". Biochemical Pharmacology. 43 (12): 2527–33. doi:10.1016/0006-2952(92)90140-E. PMID 1378736.
  4. ^ Dominici S, Paolicchi A, Corti A, Maellaro E, Pompella A (2005). "Prooxidant Reactions Promoted by Soluble and Cell-Bound γ-Glutamyltransferase Activity". Prooxidant reactions promoted by soluble and cell-bound gamma-glutamyltransferase activity. Methods in Enzymology. Vol. 401. pp. 484–501. doi:10.1016/S0076-6879(05)01029-3. ISBN 978-0-12-182806-6. PMID 16399404.
  5. ^ "EC". International Union of Biochemistry and Molecular Biology. 2011. Retrieved 9 October 2016.
  6. ^ Shaw LM, Strømme JH, London JL, Theodorsen L (December 1983). "International Federation of Clinical Chemistry. Scientific Committee, Analytical Section. Expert Panel on Enzymes. IFCC methods for measurement of enzymes. Part 4. IFCC methods for gamma-glutamyltransferase [(gamma-glutamyl)-peptide: amino acid gamma-glutamyltransferase, EC]. IFCC Document, Stage 2, Draft 2, 1983-01 with a view to an IFCC Recommendation". Clinica Chimica Acta; International Journal of Clinical Chemistry. 135 (3): 315F–338F. doi:10.1016/0009-8981(83)90291-7. PMID 6141014.
  7. ^ Goldberg DM (1980). "Structural, functional, and clinical aspects of gamma-glutamyltransferase". CRC Critical Reviews in Clinical Laboratory Sciences. 12 (1): 1–58. doi:10.3109/10408368009108725. PMID 6104563.
  8. ^ Meister A (August 1974). "The gamma-glutamyl cycle. Diseases associated with specific enzyme deficiencies". Annals of Internal Medicine. 81 (2): 247–53. doi:10.7326/0003-4819-81-2-247. PMID 4152527.
  9. ^ Raulf M, Stüning M, König W (May 1985). "Metabolism of leukotrienes by L-gamma-glutamyl-transpeptidase and dipeptidase from human polymorphonuclear granulocytes". Immunology. 55 (1): 135–47. PMC 1453575. PMID 2860060.
  10. ^ Schulman JD, Goodman SI, Mace JW, Patrick AD, Tietze F, Butler EJ (July 1975). "Glutathionuria: inborn error of metabolism due to tissue deficiency of gamma-glutamyl transpeptidase". Biochemical and Biophysical Research Communications. 65 (1): 68–74. doi:10.1016/S0006-291X(75)80062-3. PMID 238530.
  11. ^ Yokoyama H (June 2007). "[Gamma glutamyl transpeptidase (gammaGTP) in the era of metabolic syndrome]". Nihon Arukōru Yakubutsu Igakkai Zasshi = Japanese Journal of Alcohol Studies & Drug Dependence (in Japanese). 42 (3): 110–24. PMID 17665541.
  12. ^ a b West MB, Wickham S, Quinalty LM, Pavlovicz RE, Li C, Hanigan MH (19 August 2011). "Autocatalytic cleavage of human gamma-glutamyl transpeptidase is highly dependent on N-glycosylation at asparagine 95". The Journal of Biological Chemistry. 286 (33): 28876–28888. doi:10.1074/jbc.M111.248823. ISSN 1083-351X. PMC 3190695. PMID 21712391.
  13. ^ Fine A, McIntosh WB (May 1975). "Elevation of Serum Gamma-Glutamyl Transpeptidase in End-Stage Chronic Renal Failure". Scottish Medical Journal. 20 (3): 113–115. doi:10.1177/003693307502000309. ISSN 0036-9330. PMID 242073. S2CID 23177210.
  14. ^ Endre ZH, Pickering JW, Walker RJ, Devarajan P, Edelstein CL, Bonventre JV, Frampton CM, Bennett MR, Ma Q, Sabbisetti VS, Vaidya VS, Walcher AM, Shaw GM, Henderson SJ, Nejat M, Schollum JB, George PM (2 May 2011). "Improved performance of urinary biomarkers of acute kidney injury in the critically ill by stratification for injury duration and baseline renal function". Kidney International. 79 (10): 1119–1130. doi:10.1038/ki.2010.555. ISSN 0085-2538. PMC 3884688. PMID 21307838.
  15. ^ Mannion CM (2012). General Laboratory Manual (PDF). Department of Pathology, Hackensack University Medical Centre. p. 129. Retrieved 20 February 2014.
  16. ^ Betro MG, Oon RC, Edwards JB (November 1973). "Gamma-glutamyl transpeptidase in diseases of the liver and bone". American Journal of Clinical Pathology. 60 (5): 672–8. doi:10.1093/ajcp/60.5.672. PMID 4148049.
  17. ^ a b Lum G, Gambino SR (April 1972). "Serum gamma-glutamyl transpeptidase activity as an indicator of disease of liver, pancreas, or bone". Clinical Chemistry. 18 (4): 358–62. doi:10.1093/clinchem/18.4.358. PMID 5012259.
  18. ^ Lamy J, Baglin MC, Ferrant JP, Weill J (1974). "Determination de la gamma-glutamyl transpeptidase senque des ethyliques a la suite du sevrage". Clin Chim Acta. 56 (2): 169–73. doi:10.1016/0009-8981(74)90225-3. PMID 4154814.
  19. ^ a b Franzini M, Bramanti E, Ottaviano V, Ghiri E, Scatena F, Barsacchi R, Pompella A, Donato L, Emdin M, Paolicchi A (March 2008). "A high performance gel filtration chromatography method for gamma-glutamyltransferase fraction analysis". Analytical Biochemistry. 374 (1): 1–6. doi:10.1016/j.ab.2007.10.025. hdl:11382/3163. PMID 18023410.
  20. ^ Kaplan MM, Matloff DS, Selinger MJ, Quaroni EG (1985). "Biochemical basis for serum enzyme abnormalities in alcoholic liver disease". In Chang NC, Chao HM (eds.). Early identification of alcohol abuse, Proceedings of a workshop October 31–November 1, 1983. Rockville, Maryland: National Institute on Alcohol Abuse and Alcoholism. pp. 186–198. LCCN 84601128. Research Monograph No. 17.
  21. ^ Barouki R, Chobert MN, Finidori J, Aggerbeck M, Nalpas B, Hanoune J (1983). "Ethanol effects in a rat hepatoma cell line: induction of gamma-glutamyltransferase". Hepatology. 3 (3): 323–9. doi:10.1002/hep.1840030308. PMID 6132864. S2CID 84080031.
  22. ^ Rosalki SB, Tarlow D, Rau D (August 1971). "Plasma gamma-glutamyl transpeptidase elevation in patients receiving enzyme-inducing drugs". Lancet. 2 (7720): 376–7. doi:10.1016/S0140-6736(71)90093-6. PMID 4105075.
  23. ^ "Kava Uses, Benefits & Dosage". Herbal Database.
  24. ^ Emdin M, Pompella A, Paolicchi A (October 2005). "Gamma-glutamyltransferase, atherosclerosis, and cardiovascular disease: triggering oxidative stress within the plaque". Circulation. 112 (14): 2078–80. doi:10.1161/CIRCULATIONAHA.105.571919. PMID 16203922.
  25. ^ Pompella A, Emdin M, Passino C, Paolicchi A (2004). "The significance of serum gamma-glutamyltransferase in cardiovascular diseases". Clinical Chemistry and Laboratory Medicine. 42 (10): 1085–91. doi:10.1515/CCLM.2004.224. PMID 15552264. S2CID 4248204.
  26. ^ Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H (October 2005). "Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults". Circulation. 112 (14): 2130–7. doi:10.1161/CIRCULATIONAHA.105.552547. PMID 16186419.
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