Hemolytic Anemias Part 4: G6PD Deficiency; Pathophysiology,Morphology, clinical features In RBCs, NADPH are produced exclusively via HMP shunt by the action of G6PD and are responsible to maintain membrane integrity preventing premature destruction. That is why G6PD deficient RBCs are Erythrocyte and plasma oxidative stress appears to be compensated in patients with sickle cell disease during a period of relative health, despite the presence of known oxidative agents ScienceDirect L glutamine for sickle cell disease: more than reducing redox Annals of Hematology Springer Nature Link