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Leimkühler M, Bourgonje AR, van Goor H, Campmans-Kuijpers MJE, de Bock GH, van Leeuwen BL. Oxidative Stress Predicts Post-Surgery Complications in Gastrointestinal Cancer Patients. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11412-8. [PMID: 35175456 PMCID: PMC9174134 DOI: 10.1245/s10434-022-11412-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/18/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION An excessive perioperative inflammatory reaction can lead to more postoperative complications in patients treated for gastrointestinal cancers. It has been suggested that this inflammatory reaction leads to oxidative stress. The most important nonenzymatic antioxidants are serum free thiols. The purpose of this study was to evaluate whether high preoperative serum free thiol levels are associated with short-term clinical outcomes. METHODS Blood samples were drawn before, at the end of, and 1 and 2 days after surgery of a consecutive series of patients with gastrointestinal cancer. Serum free thiols were detected using a colorimetric detection method using Ellman's reagent. Short-term clinical outcomes were defined as 30-day complications (Clavien-Dindo ≥2) and length of hospital stay. Logistic regression was applied to examine the association between serum free thiol levels and short-term patient outcomes. RESULTS Eighty-one patients surgically treated for gastrointestinal cancer were included in the study. Median age was 68 (range 26-87) years, and 28% were female. Patients in the lowest tertile of preoperative serum free thiols had a threefold higher risk to develop postoperative complications (odds ratio [OR]: 3.4; 95% confidence interval [CI]:1.1-10.7) and a fourfold higher risk to have an increased length of stay in the hospital (OR 4.0; 95% CI 1.3-12.9) compared with patients in the highest tertile. CONCLUSIONS Patients with lower preoperative serum free thiol levels, indicating a decrease in extracellular antioxidant capacity and therefore an increase in systemic oxidative stress, are more likely to develop postoperative complications and show a longer in hospital stay than patients with higher serum free thiol levels.
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Affiliation(s)
- M Leimkühler
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A R Bourgonje
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H van Goor
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M J E Campmans-Kuijpers
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - G H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - B L van Leeuwen
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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Erel Ö, Erdoğan S. Thiol-disulfide homeostasis: an integrated approach with biochemical and clinical aspects. Turk J Med Sci 2020; 50:1728-1738. [PMID: 32233181 PMCID: PMC7672356 DOI: 10.3906/sag-2003-64] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022] Open
Abstract
Dynamic thiol-disulfide homeostasis (TDH) is a new area has begun to attract more scrutiny. Dynamic TDH is reversal of thiol oxidation in proteins and represents the status of thiols (-SH) and disulfides (-S-S-). Organic compounds containing the sulfhydryl group is called thiol, composed of sulfur and hydrogen atoms. Disulfides are the most important class of dynamic, redox responsive covalent bonds build in between two thiol groups. For many years, thiol levels were analyzed by several methods. During last years, measurements of disulfide levels have been analyzed by a novel automated method, developed by Erel and Neselioglu. In this method, addition to thiol (termed as native thiol) levels, disulfide levels were also measured and sum of native thiol and disulfide levels were termed as total thiol. Therefore, TDH was begun to be understood in organism. In healthy humans, TDH is maintained within a certain range. Dysregulated dynamic TDH has been implicated several disorders with unknown etiology. A growing body of evidence has demonstrated that the thiol-disulfide homeostasis is involved in variety diseases, such as diabetes mellitus, hypertension, nonsmall cell lung cancer, familial Mediterranean fever (FMF), inflammatory bowel diseases, occupational diseases, gestational diabetes mellitus and preeclampsia. These results may elucidate some pathogenic mechanism or may be a predictor indicating diagnostic clue, prognostic marker or therapeutic sign. In conclusion, protection of the thiol-disulfide homeostasis is of great importance for the human being. Evidence achieved so far has proposed that thiol-disulfide homeostasis is an important issue needs to elucidate wholly.
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Affiliation(s)
- Özcan Erel
- Department of Medical Biochemistry, Faculty of Medicine, Ankara Yıldırım Beyazıt Universty, Ankara , Turkey,Department of Medical Biochemistry, Ankara City Hospital , Ankara, Turkey
| | - Serpil Erdoğan
- Department of Medical Biochemistry, Faculty of Medicine, Ankara Yıldırım Beyazıt Universty, Ankara , Turkey
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Arıcan S, Dertli R, Baktik S, Hacibeyoglu G, Erol A, Ulukaya SO, Goger E, Erel Ö. Efeito da exposição à radiação ionizante de baixa dose na homeostase dinâmica de tiol‐dissulfeto e níveis de albumina modificada por isquemia: estudo observacional. Braz J Anesthesiol 2020; 70:233-239. [DOI: 10.1016/j.bjan.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/11/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022] Open
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Braz MG, Carvalho LIM, Chen CYO, Blumberg JB, Souza KM, Arruda NM, Filho DAA, Resende LO, Faria RTBG, Canário CD, de Carvalho LR, Corrêa CR, Braz JRC, Braz LG. High concentrations of waste anesthetic gases induce genetic damage and inflammation in physicians exposed for three years: A cross-sectional study. INDOOR AIR 2020; 30:512-520. [PMID: 31930534 DOI: 10.1111/ina.12643] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
This cross-sectional study analyzed the impact of occupational waste anesthetic gases on genetic material, oxidative stress, and inflammation status in young physicians exposed to inhalational anesthetics at the end of their medical residency. Concentrations of waste anesthetic gases were measured in the operating rooms to assess anesthetic pollution. The exposed group comprised individuals occupationally exposed to inhalational anesthetics, while the control group comprised individuals without anesthetic exposure. We quantified DNA damage; genetic instability (micronucleus-MN); protein, lipid, and DNA oxidation; antioxidant activities; and proinflammatory cytokine levels. Trace concentrations of anesthetics (isoflurane: 5.3 ± 2.5 ppm, sevoflurane: 9.7 ± 5.9 ppm, and nitrous oxide: 180 ± 150 ppm) were above international recommended thresholds. Basal DNA damage and IL-17A were significantly higher in the exposed group [27 ± 20 a.u. and 20.7(19.1;31.8) pg/mL, respectively] compared to the control group [17 ± 11 a.u. and 19.0(18.9;19.5) pg/mL, respectively], and MN frequency was slightly increased in the exposed physicians (2.3-fold). No significant difference was observed regarding oxidative stress biomarkers. The findings highlight the genetic and inflammatory risks in young physicians exposed to inhalational agents in operating rooms lacking adequate scavenging systems. This potential health hazard can accompany these subjects throughout their professional lives and reinforces the need to reduce ambient air pollution and consequently, occupational exposure.
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Affiliation(s)
- Mariana G Braz
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
- Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Lorena I M Carvalho
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
- Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Chung-Yen O Chen
- Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Jeffrey B Blumberg
- Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Kátina M Souza
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Nayara M Arruda
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Daniel A A Filho
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Ludimila O Resende
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Renata T B G Faria
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Clara d'A Canário
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Lídia R de Carvalho
- Department of Bioestatistics, Institute of Biosciences, São Paulo State University - UNESP, Botucatu, Brazil
| | - Camila R Corrêa
- Department of Pathology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - José Reinaldo C Braz
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Leandro G Braz
- GENOTOX Laboratory - UNIPEX, Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
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Arıcan S, Dertli R, Baktik S, Hacibeyoglu G, Erol A, Ulukaya SO, Goger E, Erel Ö. The effect of low dose ionizing radiation exposure on dynamic thiol-disulfide homeostasis and ischemia modified albumin levels: an observational study. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2020. [PMID: 32482354 PMCID: PMC9373708 DOI: 10.1016/j.bjane.2020.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background The primary objective of this study was to investigate the effect of low dose ionizing radiation exposure on thiol/disulfide homeostasis and ischemia modified albumin levels. The secondary objective is to compare thiol/disulfide homeostasis and ischemia modified albumin levels among the personnel exposed to low dose ionizing radiation in anesthesia application areas, in and out of the operation room. Methods The study included a total of 90 volunteers aged between 18 and 65 years old, with 45 personnel working in a setting with potential for radiation exposure (Exposed Group) and 45 personnel in a setting without radiation exposure (Control Group). Their native thiol, total thiol, disulphide, albumine and IMA levels were measured. Exposed group included personnel who were exposed to radiation outside the operating room – Operation room (−) Group and inside the operating room – Operation room (+) Group. Results Albumin, native and total thiol levels were significantly lower in the participants exposed to radiation in the anesthesia application area; no statistically significant difference was found in terms of disulfide and ischemia modified albumin levels. In the Operation room (−) Group exposed to radiation, native thiol and total thiol values were significantly lower compared to the Operation room (+) Group. Conclusion Awareness of being in danger of oxidative stress should be established in personnel exposed to radiation in the anesthesia application area following low dose ionizing radiation exposure, and the necessary measures should be taken.
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Affiliation(s)
- Sule Arıcan
- University of Necmettin Erbakan, Medical Faculty, Department of Anaesthesiology, Konya, Turkey.
| | - Ramazan Dertli
- University of Necmettin Erbakan, Medical Faculty, Department of Gastroenterology, Konya, Turkey
| | - Suleyman Baktik
- University of Necmettin Erbakan, Medical Faculty, Department of Radiology, Konya, Turkey
| | - Gulcin Hacibeyoglu
- University of Necmettin Erbakan, Medical Faculty, Department of Anaesthesiology, Konya, Turkey
| | - Atilla Erol
- University of Necmettin Erbakan, Medical Faculty, Department of Anaesthesiology, Konya, Turkey
| | - Sinan Oguzhan Ulukaya
- University of Necmettin Erbakan, Medical Faculty, Department of Anaesthesiology, Konya, Turkey
| | - Esra Goger
- University of Necmettin Erbakan, Medical Faculty, Department of Anaesthesiology, Konya, Turkey
| | - Özcan Erel
- University of Yildirim Beyazit, Medical Faculty, Department of Medical Biochemistry, Ankara, Turkey
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