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Alobaidy ASH, Elhelaly M, Amer ME, Shemies RS, Othman AI, El-Missiry MA. Angiotensin converting enzyme 2 gene expression and markers of oxidative stress are correlated with disease severity in patients with COVID-19. Mol Biol Rep 2023:10.1007/s11033-023-08515-0. [PMID: 37222866 DOI: 10.1007/s11033-023-08515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Oxidative stress is thought to play a significant role in the pathogenesis and severity of COVID-19. Additionally, angiotensin converting enzyme 2 (ACE2) expression may predict the severity and clinical course of COVID-19. Accordingly, the aim of the present study was to evaluate the association of oxidative stress and ACE2 expression with the clinical severity in patients with COVID-19. METHODS AND RESULTS The present study comprised 40 patients with COVID-19 and 40 matched healthy controls, recruited between September 2021 and March 2022. ACE 2 expression levels were measured using Hera plus SYBR Green qPCR kits with GAPDH used as an internal control. Serum melatonin (MLT) levels, serum malondialdehyde (MDA) levels, and total antioxidant capacity (TAC) were estimated using ELISA. The correlations between the levels of the studied markers and clinical indicators of disease severity were evaluated. Significantly, lower expression of ACE2 was observed in COVID-19 patients compared to controls. Patients with COVID-19 had lower serum levels of TAC and MLT but higher serum levels of MDA compared to normal controls. Serum MDA levels were correlated with diastolic blood pressure (DBP), Glasgow coma scale (GCS) scores, and serum potassium levels. Serum MLT levels were positively correlated with DBP, mean arterial pressure (MAP), respiratory rate, and serum potassium levels. TAC was correlated with GCS, mean platelet volume, and serum creatinine levels. Serum MLT levels were significantly lower in patients treated with remdesivir and inotropes. Receiver operating characteristic curve analysis demonstrates that all markers had utility in discriminating COVID-19 patients from healthy controls. CONCLUSIONS Increased oxidative stress and increased ACE2 expression were correlated with disease severity and poor outcomes in hospitalized patients with COVID-19 in the present study. Melatonin supplementation may provide a utility as an adjuvant therapy in decreasing disease severity and death in COVID-19 patients.
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Affiliation(s)
- Afraa S H Alobaidy
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Mona Elhelaly
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Maggie E Amer
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Rasha S Shemies
- Mansoura Nephrology and Dialysis Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Azza I Othman
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
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Izumino H, Tajima G, Tasaki O, Inokuma T, Hatachi G, Takagi K, Miyazaki T, Matsumoto K, Tsuchiya T, Sato S, Nagayasu T. Balance of the prooxidant and antioxidant system is associated with mortality in critically ill patients. J Clin Biochem Nutr 2023; 72:157-164. [PMID: 36936878 PMCID: PMC10017322 DOI: 10.3164/jcbn.22-79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/06/2022] [Indexed: 01/28/2023] Open
Abstract
It is well known that oxidative stress causes certain diseases and organ damage. However, roles of oxidative stress in the acute phase of critical patients remain to be elucidated. This study aimed to investigate the balance of oxidative and antioxidative system and to clarify the association between oxidative stress and mortality in critically ill patients. This cohort study enrolled 247 patients transported to our emergency department by ambulance. Blood was drawn on hospital arrival, and serum derivatives of reactive oxidant metabolites (dROMs, oxidative index) and biological antioxidant potential (BAP, antioxidative index) were measured. Modified ratio (MR) is also calculated as BAP/dROMs/7.51. There were 197 survivors and 50 non-survivors. In the non-survivors, dROMs were significantly lower (274 vs 311, p<0.01), BAP was significantly higher (2,853 vs 2,138, p<0.01), and MR was significantly higher (1.51 vs 0.92, p<0.01) compared to those in the survivors. The AUC of MR was similar to that for the APACHE II score. Contrary to our expectations, higher BAP and lower dROMs were observed on admission in non-survivors. This may suggest that the antioxidative system is more dominant in the acute phase of severe insults and that the balance toward a higher antioxidative system is associated with mortality.
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Affiliation(s)
- Hiroo Izumino
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
- Acute and Critical Care Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Goro Tajima
- Acute and Critical Care Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Emergency Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
- To whom correspondence should be addressed. E-mail:
| | - Osamu Tasaki
- Acute and Critical Care Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Emergency Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Takamitsu Inokuma
- Acute and Critical Care Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Go Hatachi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Katsunori Takagi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Takuro Miyazaki
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Keitaro Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Tomoshi Tsuchiya
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
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Gtif I, Abdelhedi R, Ouarda W, Bouzid F, Charfeddine S, Zouari F, Abid L, Rebai A, Kharrat N. Oxidative stress markers-driven prognostic model to predict post-discharge mortality in heart failure with reduced ejection fraction. Front Cardiovasc Med 2022; 9:1017673. [DOI: 10.3389/fcvm.2022.1017673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
BackgroundCurrent predictive models based on biomarkers reflective of different pathways of heart failure with reduced ejection fraction (HFrEF) pathogenesis constitute a useful tool for predicting death risk among HFrEF patients. The purpose of the study was to develop a new predictive model for post-discharge mortality risk among HFrEF patients, based on a combination of clinical patients’ characteristics, N-terminal pro-B-type Natriuretic peptide (NT-proBNP) and oxidative stress markers as a potentially valuable tool for routine clinical practice.Methods116 patients with stable HFrEF were recruited in a prospective single-center study. Plasma levels of NT-proBNP and oxidative stress markers [superoxide dismutase (SOD), glutathione peroxidase (GPX), uric acid (UA), total bilirubin (TB), gamma-glutamyl transferase (GGT) and total antioxidant capacity (TAC)] were measured in the stable predischarge condition. Generalized linear model (GLM), random forest and extreme gradient boosting models were developed to predict post-discharge mortality risk using clinical and laboratory data. Through comprehensive evaluation, the most performant model was selected.ResultsDuring a median follow-up of 525 days (7–930), 33 (28%) patients died. Among the three created models, the GLM presented the best performance for post-discharge death prediction in HFrEF. The predictors included in the GLM model were age, female sex, beta blockers, NT-proBNP, left ventricular ejection fraction (LVEF), TAC levels, admission systolic blood pressure (SBP), angiotensin-converting enzyme inhibitors/angiotensin receptor II blockers (ACEI/ARBs) and UA levels. Our model had a good discriminatory power for post-discharge mortality [The area under the curve (AUC) = 74.5%]. Based on the retained model, an online calculator was developed to allow the identification of patients with heightened post-discharge death risk.ConclusionIn conclusion, we created a new and simple tool that may allow the identification of patients at heightened post-discharge mortality risk and could assist the treatment decision-making.
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Shokri-Mashhadi N, Aliyari A, Hajhashemy Z, Saadat S, Rouhani MH. Is it time to reconsider the administration of thiamine alone or in combination with vitamin C in critically ill patients? A meta-analysis of clinical trial studies. J Intensive Care 2022; 10:8. [PMID: 35177121 PMCID: PMC8851730 DOI: 10.1186/s40560-022-00594-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/04/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Although the effect of thiamine alone or in combination with vitamin C has been studied in multiple trials (RCT and interventional studies), their results are inconsistent. This meta-analysis aimed to assess impact of thiamine administration alone, thiamine in combination with vitamin C, and co-administration of low-dose hydrocortisone, vitamin C and thiamine (HVT) on clinical outcomes in critically ill patients. METHODS AND MATERIALS After electronic searches on PubMed, Scopus, Cochrane Library, and Web of Science databases, initially 3367 papers were found, and 20 interventional studies were included in our analysis. We assessed the risk-difference between treatment and control (standard treatment) groups by pooling available data on ICU length of stay, number of ventilator free days, mortality, and changes in Sequential Organ Failure Assessment (SOFA) scores. RESULTS The results of present studies revealed no significant effect of thiamine in combination with vitamin C, and HVT on number of free days of ventilation. Thiamine alone supplementation was associated with high mortality percentage (WMD: 5.17%; 95% CI: 2.67, 7.67). Thiamine in combination with vitamin C had no significant impact on mortality rate. In contrast, HVT could decrease mortality rate (WMD: - 7.23%; 95% CI: - 10.31, - 4.16; I-square: 0.0%). There was no significant effect of thiamine alone, co-administration of thiamine and vitamin C, and HVT on ICU length of stay. The results of the meta-analysis showed that thiamine alone and HVT supplementation had no significant effect on SOFA score. Interestingly, co-supplementation of thiamine and vitamin C had a significant decreasing effect on SOFA score (WMD: - 0.73; 95% CI: - 1.29, - 0.17; I-square: 0.0%). CONCLUSION In contrast to HVT, thiamine supplementation alone was associated with increased mortality rate in ICU. However, co-supplementation of thiamine and vitamin C had a significant decreasing effect on SOFA score.
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Affiliation(s)
- Nafiseh Shokri-Mashhadi
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Aliyari
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Saadat
- Faculty of Mathematics and Natural Sciences, Department of Computer Sciences, Heinrich Heine Universität, Düsseldorf, Germany
| | - Mohammad Hossein Rouhani
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Oxidant/Antioxidant Status Is Impaired in Sepsis and Is Related to Anti-Apoptotic, Inflammatory, and Innate Immunity Alterations. Antioxidants (Basel) 2022; 11:antiox11020231. [PMID: 35204114 PMCID: PMC8868413 DOI: 10.3390/antiox11020231] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/17/2022] [Accepted: 01/23/2022] [Indexed: 02/04/2023] Open
Abstract
Oxidative stress is considered pivotal in the pathophysiology of sepsis. Oxidants modulate heat shock proteins (Hsp), interleukins (IL), and cell death pathways, including apoptosis. This multicenter prospective observational study was designed to ascertain whether an oxidant/antioxidant imbalance is an independent sepsis discriminator and mortality predictor in intensive care unit (ICU) patients with sepsis (n = 145), compared to non-infectious critically ill patients (n = 112) and healthy individuals (n = 89). Serum total oxidative status (TOS) and total antioxidant capacity (TAC) were measured by photometric testing. IL-6, -8, -10, -27, Hsp72/90 (ELISA), and selected antioxidant biomolecules (Ζn, glutathione) were correlated with apoptotic mediators (caspase-3, capsase-9) and the central anti-apoptotic survivin protein (ELISA, real-time PCR). A wide scattering of TOS, TAC, and TOS/TAC in all three groups was demonstrated. Septic patients had an elevated TOS/TAC, compared to non-infectious critically ill patients and healthy individuals (p = 0.001). TOS/TAC was associated with severity scores, procalcitonin, IL-6, -10, -27, IFN-γ, Hsp72, Hsp90, survivin protein, and survivin isoforms -2B, -ΔΕx3, -WT (p < 0.001). In a propensity probability (age-sex-adjusted) logistic regression model, only sepsis was independently associated with TOS/TAC (Exp(B) 25.4, p < 0.001). The AUCTOS/TAC (0.96 (95% CI = 0.93–0.99)) was higher than AUCTAC (z = 20, p < 0.001) or AUCTOS (z = 3.1, p = 0.002) in distinguishing sepsis. TOS/TAC, TOS, survivin isoforms -WT and -2B, Hsp90, IL-6, survivin protein, and repressed TAC were strong predictors of mortality (p < 0.01). Oxidant/antioxidant status is impaired in septic compared to critically ill patients with trauma or surgery and is related to anti-apoptotic, inflammatory, and innate immunity alterations. The unpredicted TOS/TAC imbalance might be related to undefined phenotypes in patients and healthy individuals.
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Masomi-Bornwasser J, Kurz E, Frenz C, Schmitt J, Wesp DMA, König J, Lotz J, Ringel F, Kerz T, Krenzlin H, Keric N. The Influence of Oxidative Stress on Neurological Outcomes in Spontaneous Intracerebral Hemorrhage. Biomolecules 2021; 11:1615. [PMID: 34827613 PMCID: PMC8615528 DOI: 10.3390/biom11111615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Spontaneous intracerebral hemorrhage (ICH) causes, besides the primary brain injury, a secondary brain injury (SBI), which is induced, amongst other things, by oxidative stress (OS) and inflammation, determining the patient's outcome. This study aims to assess the impact of OS in plasma and cerebrospinal fluid (CSF) on clinical outcomes in patients with ICH. A total of 19 ICH (volume > 30 cc) patients and 29 control patients were included. From day one until seven, blood and CSF samples were obtained, and ICH volume was calculated. OS markers, like malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione-sulfhydryl (GSH), and the total antioxidant status (TAS) were measured. Clinical data on treatment and outcome were determined. Patients with mRS ≤ 4 showed significantly elevated SOD and GSH-Px levels in plasma compared to patients with poor CO (p = 0.004; p = 0.002). Initial increased TAS in plasma and increased MDA in CSF were linked to an unfavorable outcome after six months (p = 0.06, r = 0.45; p = 0.05, r = 0.44). A higher ICH volume was associated with a worse outcome at week six (p = 0.04, r = 0.47). OS plays a significant role in SBI. Larger ICHs, elevated MDA in CSF, and TAS in plasma were associated with a detrimental outcome, whereas higher plasma-SOD and -GSH-Px were associated with a favorable outcome.
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Affiliation(s)
- Julia Masomi-Bornwasser
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Elena Kurz
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Christina Frenz
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Jan Schmitt
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Dominik M. A. Wesp
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Johannes Lotz
- Institute of Clinical and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Thomas Kerz
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Harald Krenzlin
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
| | - Naureen Keric
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.K.); (C.F.); (J.S.); (D.M.A.W.); (F.R.); (T.K.); (H.K.); (N.K.)
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ŞEKEROĞLU MR, ÇOKLUK E, YAYLACI S, ERDEM AF, TUNCER FB, DHEİR H, GÜÇLÜ E, ÖĞÜTLÜ A, ÇEKİÇ D, AYDIN A, SERİNKAN CİNEMRE FB. Thiol-Disulphide Homoeostasis in COVID-19: Evaluation of its Relationship with Complete Blood Count Parameters. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.917364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Glutathione Reductase Is Associated with the Clinical Outcome of Septic Shock in the Patients Treated Using Continuous Veno-Venous Haemofiltration. ACTA ACUST UNITED AC 2021; 57:medicina57070689. [PMID: 34356970 PMCID: PMC8307392 DOI: 10.3390/medicina57070689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022]
Abstract
Background and objectives: At present, there is insufficient evidence to support the use of continuous veno-venous haemofiltration (CVVH) in the early treatment of septic shock. This study focuses on the association between survival and different parameters of oxidative stress (RedOx). Thereby, we evaluated whether RedOx markers are associated with the outcome of septic shock in patients under early-initiated CVVH treatment. Materials and Methods: We conducted a prospective observational study of 65 patients with septic shock who started CVVH within 12 h after hospital admission. Blood samples were taken from each patient prior to the start of CVVH. The following RedOx markers were measured: glutathione peroxidase, glutathione reductase (GR), total antioxidant capacity, superoxide dismutase, nitric oxide, malondialdehyde and 4-hydroxynonenal. The odds ratio (OR) was calculated using binary logistic regression and stepwise multivariable regression. Results: The 65 patients had a median age of 66 years and 39 were male. Based on the outcome, the patients were divided into two groups—non-survivors (n = 29) and survivors (n = 36)—and the levels of RedOx markers were compared between them. Of all the markers, only higher GR activity was found to be significantly associated with the fatal outcome; 100.3 U/L versus 60.5 U/L, OR = 1.027 (95% CI, 1.010–1.044). Following adjustment for the sequential organ failure assessment score and other parameters, GR activity still presented a significant association with the fatal outcome, OR = 1.020 (95% CI, 1.002–1.038). Conclusions: GR activity is associated with in-hospital fatal outcomes among septic shock patients under early-initiated CVVH treatment. Septic shock patients who have a lower GR activity at hospital admission may have a favourable outcome of the early initiation of CVVH.
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McKeever L, Peterson SJ, Lateef O, Braunschweig C. The Influence of Timing in Critical Care Nutrition. Annu Rev Nutr 2021; 41:203-222. [PMID: 34143642 DOI: 10.1146/annurev-nutr-111120-114108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Proper timing of critical care nutrition has long been a matter of controversy. Critical illness waxes and wanes in stages, creating a dynamic flux in energy needs that we have only begun to examine. Furthermore, response to nutrition support likely differs greatly at the level of the individual patient in regard to genetic status, disease stage, comorbidities, and more. We review the observational and randomized literature concerning timing in nutrition support, discuss mechanisms of harm in feeding critically ill patients, and highlight the role of precision nutrition for moving the literature beyond the realm of blunt population averages into one that accounts for the patient-specific complexities of critical illness and host genetics. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Liam McKeever
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania 19063, USA;
| | - Sarah J Peterson
- Department of Clinical Nutrition, Rush University Medical Center, Chicago, Illinois 60612, USA
| | - Omar Lateef
- Department of Clinical Nutrition, Rush University Medical Center, Chicago, Illinois 60612, USA
| | - Carol Braunschweig
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois 60612, USA;
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Lymphaticovenous Anastomosis Supermicrosurgery Decreases Oxidative Stress and Increases Antioxidant Capacity in the Serum of Lymphedema Patients. J Clin Med 2021; 10:jcm10071540. [PMID: 33917571 PMCID: PMC8038828 DOI: 10.3390/jcm10071540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Excess lymphedematous tissue causes excessive oxidative stress in lymphedema. Lymphaticovenous anastomosis (LVA) supermicrosurgery is currently emerging as the first-line surgical intervention for lymphedema. No data are available regarding the changes in serum proteins correlating to oxidative stress and antioxidant capacity before and after LVA. METHODS A total of 26 patients with unilateral lower limb lymphedema confirmed by lymphoscintigraphy were recruited, and venous serum samples were collected before (pre-LVA) and after LVA (post-LVA). In 16 patients, the serum proteins were identified by isobaric tags for relative and absolute quantitation-based quantitative proteomic analysis with subsequent validation of protein expression by enzyme-linked immunosorbent assay. An Oxidative Stress Panel Kit was used on an additional 10 patients. Magnetic resonance (MR) volumetry was used to measure t limb volume six months after LVA. RESULTS This study identified that catalase (CAT) was significantly downregulated after LVA (pre-LVA vs. post-LVA, 2651 ± 2101 vs. 1448 ± 593 ng/mL, respectively, p = 0.033). There were significantly higher levels of post-LVA serum total antioxidant capacity (pre-LVA vs. post-LVA, 441 ± 81 vs. 488 ± 59 µmole/L, respectively, p = 0.031) and glutathione peroxidase (pre-LVA vs. post-LVA, 73 ± 20 vs. 92 ± 29 U/g, respectively, p = 0.018) than pre-LVA serum. In addition, after LVA, there were significantly more differences between post-LVA and pre-LVA serum levels of CAT (good outcome vs. fair outcome, -2593 ± 2363 vs. 178 ± 603 ng/mL, respectively, p = 0.021) and peroxiredoxin-2 (PRDX2) (good outcome vs. fair outcome, -7782 ± 7347 vs. -397 ± 1235 pg/mL, respectively, p = 0.037) in those patients with good outcomes (≥40% volume reduction in MR volumetry) than those with fair outcomes (<40% volume reduction in MR volumetry). CONCLUSIONS The study revealed that following LVA, differences in some specific oxidative stress markers and antioxidant capacity can be found in the serum of patients with lymphedema.
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Decreased Superoxide Dismutase Concentrations (SOD) in Plasma and CSF and Increased Circulating Total Antioxidant Capacity (TAC) Are Associated with Unfavorable Neurological Outcome after Aneurysmal Subarachnoid Hemorrhage. J Clin Med 2021; 10:jcm10061188. [PMID: 33809085 PMCID: PMC7999673 DOI: 10.3390/jcm10061188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Subarachnoid hemorrhage (SAH) is a devastating disease with high morbidity and mortality. Hypoxia-induced changes and hemoglobin accumulation within the subarachnoid space are thought to lead to oxidative stress, early brain injury, and delayed vasospasm. This study aimed to evaluate the antioxidant status and its impact on neurological outcome in patients with aneurysmal SAH. Methods: In this prospective observational study, 29 patients with aneurysmal SAH were included (mean age 54.7 ± 12.4). Blood and cerebrospinal fluid (CSF) samples were collected on days (d) 1, 3, and 7. In addition, 29 patients without intracranial hemorrhage served as controls. The antioxidant system was analyzed by glutathione peroxidase (GSH-Px; U/L) and total and free glutathione-sulfhydryl (GSH; mg/L) in the plasma. Superoxide dismutase (SOD, U/mL) and total antioxidant capacity (TAC, µmol/L) were measured in the serum and CSF. Clinical data were compiled on admission (Hunt and Hess grade, Fisher grade, and GCS). Neurological and cognitive outcome (modified Rankin scale (mRS), Glasgow Outcome Scale Extended (GOSE) and Montreal Cognitive Assessment (MoCA)) was assessed after 6 weeks (6 w) and 6 months (6 m). Results: Plasma levels of SOD increased from day 1 to 7 after SAH (d1: 1.22 ± 0.36 U/L; d3: 1.25 ± 0.33 U/L, p = 0.99; d7: 1.52 ± 0.4 U/L, p = 0.019) and were significantly higher compared to controls (1.11 ± 0.27 U/L) at day 7 (p < 0.001). Concordantly, CSF levels of SOD increased from day 1 to 7 after SAH (d1: 1.22 ± 0.41 U/L; d3: 1.77 ± 0.73 U/L, p = 0.10; d7: 2.37 ± 1.29 U/L, p < 0.0001) without becoming significantly different compared to controls (1.74 ± 0.8 U/L, p = 0.09). Mean plasma TAC at day 1 (d1: 77.87 ± 49.72 µmol/L) was not statistically different compared to controls (46.74 ± 32.42 µmol/L, p = 0.25). TAC remained unchanged from day 1 to 7 (d3: 92.64 ± 68.58 µmol/L, p = 0.86; d7: 74.07 ± 54.95 µmol/L, p = 0.8) in plasma. TAC in CSF steeply declined from day 1 to 7 in patients with SAH becoming significantly different from controls at days 3 and 7 (d3: 177.3 ± 108.7 µmol/L, p = 0.0046; d7: 85.35 ± 103.9 µmol/L, p < 0.0001). Decreased SOD levels in plasma and CSF are associated with a worse neurological outcome 6 weeks (mRS: CSF p = 0.0001; plasma p = 0.027/GOSE: CSF p = 0.001; plasma p = 0.001) and 6 months (mRS: CSF p = 0.001; plasma p = 0.09/GOSE: CSF p = 0.001; plasma p = 0.001) after SAH. Increased plasma TAC correlated with a worse neurological outcome 6 weeks (mRS: p = 0.001/GOSE p = 0.001) and 6 months (mRS p = 0.001/GOSE p = 0.001) after SAH. Conclusion: In our study, a reduction in the antioxidative enzyme SOD and elevated TAC were associated with a poorer neurological outcome reflected by mRS and GOSE at 6 weeks and 6 months after SAH. A lower initial SOD CSF concentration was associated with the late deterioration of cognitive ability. These findings support the mounting evidence of the role of oxidative stress in early brain injury formation and unfavorable outcome after SAH.
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Mousavi SM, Hajishafiee M, Clark CCT, Borges do Nascimento IJ, Milajerdi A, Amini MR, Esmaillzadeh A. Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2020; 161:105166. [PMID: 32828910 DOI: 10.1016/j.phrs.2020.105166] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/08/2020] [Accepted: 08/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oxidative stress plays an important role in the occurrence of chronic diseases. Zinc supplementation is also known to be an antioxidant agent. While, there is no review on the effects of zinc supplementation on oxidative stress, this study aimed to systematically summarize randomized clinical trials (RCTs) which have evaluated the impacts of zinc supplementation on oxidative stress biomarkers. METHODS Systematic searches were performed using the PubMed/Medline, Scopus, and Google Scholar databases, up to April 2020. All RCTs assessed the effect of oral zinc supplementation on serum malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and nitric oxide (NO) levels, were included. For each variable, mean differences (MD) and standard deviations (SDs) were combined using the random-effects model, and the fractional polynomial model was used to implement the dose-response analysis. RESULTS Ten RCTs were included. The pooled analysis of data showed that zinc supplementation significantly reduced MDA levels (MD: -0.42 μmol/L; 95 % CI: -0.71 to -0.13), increased serum TAC (MD: 225.96 mmol/L; 95 % CI: 68.42-383.5) and GSH levels (MD: 49.99 μmol/L; 95 % CI: 2.25 t 97.73), compared with the placebo group. In contrast, no significant changes were seen in NO levels following zinc supplementation (MD: -1.66 μmol/L; 95 % CI: -5.89 to 2.57). Dose-response analysis showed a significant non-linear relationship between zinc supplementation dosage and serum levels of MDA (p < 0.01), but not other biomarkers. CONCLUSIONS The current study showed that zinc supplementation would significantly decrease MDA and increase TAC and GSH, but not NO levels. Thus, it encourages the use of zinc supplementation in oxidative stress-related diseases.
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Affiliation(s)
- Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hajishafiee
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV15FB, UK
| | - Israel Júnior Borges do Nascimento
- University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; School of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Alireza Milajerdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Reza Amini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.
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YILDIZ H. Thiol/disulphide homeostasis in intensive care unit patients with sepsis and septic shock. Turk J Med Sci 2020; 50:811-816. [PMID: 32233178 PMCID: PMC7379464 DOI: 10.3906/sag-1905-148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 03/28/2020] [Indexed: 12/11/2022] Open
Abstract
Background/aim Sepsis is a condition caused by infection followed by unregulated inflammatory response which may lead to organ dysfunction. The aim of this study is to be the first in the literature and it has been designed to show the thiol/disulphide changes in patients with sepsis and septic shock and their correlation with acute phase reactants. Material and methods A total of 113 patients (septic shock 53 and sepsis 60) and 60 healthy control subjects have been enrolled in this study from the period February 2018 to 2019. The patients were divided in 2 groups: nonsurvivors (74) and survivors (39). The investigation includes measurements of native thiol, total thiol, dynamic disulphide bond, oxidized thiol ratio, reduced thiol ratio and thiol oxidation reduction ratio, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin. Results The findings of this study suggest that changes in thiol levels play a role in the pathogenesis of patients with sepsis and septic shock. Conclusions Thiol/disulphide homeostasis is impaired in patients with sepsis and septic shock. Understanding the role of thiol/ disulphide homeostasis in sepsis and septic shock may provide different therapeutic intervention strategies for patients.
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Affiliation(s)
- Hamit YILDIZ
- Department of Internal Medical Sciences and Critical Care, Faculty of Medicine, Gaziantep University, GaziantepTurkey
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Fu D, Shen J, Shi H. Sevoflurane suppresses oxidation-induced stress and inflammatory responses, via promotion of Nrf2-induced antioxidant signaling. ALL LIFE 2020. [DOI: 10.1080/26895293.2020.1729868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Deshui Fu
- Department of Anesthesiology, The Second People's Hospital of Yuhang District, Hangzhou, People’s Republic of China
| | - Jufang Shen
- Department of Anesthesiology, The Second People's Hospital of Yuhang District, Hangzhou, People’s Republic of China
| | - Huimin Shi
- Department of Anesthesiology, The Second People's Hospital of Yuhang District, Hangzhou, People’s Republic of China
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Parenteral Succinate Reduces Systemic ROS Production in Septic Rats, but It Does Not Reduce Creatinine Levels. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:1928945. [PMID: 30524651 PMCID: PMC6247384 DOI: 10.1155/2018/1928945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 10/02/2018] [Accepted: 10/18/2018] [Indexed: 12/26/2022]
Abstract
In sepsis, reactive oxygen species (ROS) production is increased. This process takes place mainly within the electron transport chain. ROS production is part of the pathophysiology of multiple organ failure in sepsis. Succinate yields Dihydroflavine-Adenine Dinucleotide (FADH2), which enters the chain through complex II, avoiding complex I, through which electrons are lost. The aim of this work is to determine if parenteral succinate reduces systemic ROS production and improves kidney function. Rats with cecal ligation and puncture were used as model of sepsis, and 4 groups were made: Control group; Succinate group, which only received parenteral succinate; Sepsis group; and Sepsis which received parenteral succinate. Systemic ROS are measured 24 hours after the procedure. Rats subjected to cecal puncture treated with succinate had less systemic ROS than Septic untreated rats (p = 0.007), while there were no differences in creatinine levels (p = 0.07). There was no correlation between creatinine and systemic ROS levels (p = 0.3). We concluded that parenteral succinate reduces ROS levels, but it does not reduce creatinine levels. Since there is no correlation between both levels, the processes would not be related.
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Lorente L, Martín MM, Pérez-Cejas A, Barrios Y, Solé-Violán J, Ferreres J, Labarta L, Díaz C, Jiménez A. Association between Interleukin-6 Promoter Polymorphism (-174 G/C), Serum Interleukin-6 Levels and Mortality in Severe Septic Patients. Int J Mol Sci 2016; 17:ijms17111861. [PMID: 27834822 PMCID: PMC5133861 DOI: 10.3390/ijms17111861] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/01/2016] [Accepted: 11/04/2016] [Indexed: 12/29/2022] Open
Abstract
The association between interleukin (IL)-6 promoter polymorphism (-174 G/C), circulating IL-6 levels and mortality in septic patients has scarcely been addressed, and then only in studies of small sample size, and a direct association among them has not been previously reported. Therefore, the purpose of our study was to determine whether this association exists. An observational, prospective and multicenter study including severe septic patients was undertaken and serum IL-6 levels at severe sepsis diagnosis and IL-6 promoter polymorphism (-174 G/C) were determined. The end-point of the study was 30-day mortality. The study included 263 patients with the following genotypes of IL-6 promoter polymorphism (-174 G/C): 123 (46.8%) GG, 110 (41.8%) GC and 30 (11.4%) CC. CC homozygous patients showed lower sepsis-related organ failure assessment (SOFA) score, serum IL-6 levels and mortality at 30 days compared to those with other genotypes (GC or GG). On regression analysis, CC homozygous patients showed lower 30-day mortality than those with genotype GG (odds ratio = 0.21; 95% CI = 0.053−0.838; p = 0.03) or GC (hazard ratio = 0.28; 95% CI = 0.074−1.037; p = 0.06). The most important results of our study were that CC might be a favorable genotype in septic patients showing lower serum IL-6 levels and lower risk of death within 30 days.
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Affiliation(s)
- Leonardo Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain.
| | - María M Martín
- Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n, 38010 Santa Cruz de Tenerife, Spain.
| | - Antonia Pérez-Cejas
- Laboratory Deparment, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain.
| | - Ysamar Barrios
- Research Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain.
| | - Jordi Solé-Violán
- Intensive Care Unit, Hospital Universitario Dr. Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain.
| | - José Ferreres
- Intensive Care Unit, Hospital Clínico Universitario de Valencia, Avda, Blasco Ibáñez nº17, 46004 Valencia, Spain.
| | - Lorenzo Labarta
- Intensive Care Unit, Hospital San Jorge de Huesca, Avenida Martínez de Velasco nº36, 22004 Huesca, Spain.
| | - César Díaz
- Intensive Care Unit, Hospital Insular, Plaza Dr. Pasteur s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Alejandro Jiménez
- Research Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna-38320, 38320 Santa Cruz de Tenerife, Spain.
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Rubio CP, Hernández-Ruiz J, Martinez-Subiela S, Tvarijonaviciute A, Ceron JJ. Spectrophotometric assays for total antioxidant capacity (TAC) in dog serum: an update. BMC Vet Res 2016; 12:166. [PMID: 27526688 PMCID: PMC4986369 DOI: 10.1186/s12917-016-0792-7] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/03/2016] [Indexed: 12/20/2022] Open
Abstract
The aim of this review is to study the main spectrophotometric methods used to evaluate total antioxidant capacity (TAC) in serum samples of dogs. Total antioxidant capacity (TAC) is an analyte frequently used to assess the antioxidant status of biological samples and can evaluate the antioxidant response against the free radicals produced in a given disease. Trolox equivalent antioxidant capacity (TEAC), ferric reducing ability of plasma (FRAP), and cupric reducing antioxidant capacity (CUPRAC) are different assays described to determine TAC of a sample. This review explains the basis of each assay and their application in the determination of TAC in dogs, and also provides selected information about reports in humans for comparative purposes. It is concluded that, ideally, various different assays integrated in a panel should be used for TAC evaluation, since depending on the assay performed TAC results can be markedly different.
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Affiliation(s)
- Camila Peres Rubio
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, Faculty of Veterinary Medicine, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Josefa Hernández-Ruiz
- Department of Plant Biology (Plant Physiology), Faculty of Biology, University of Murcia, Murcia, Spain
| | - Silvia Martinez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, Faculty of Veterinary Medicine, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, Faculty of Veterinary Medicine, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Espinardo, Murcia, Spain.,Department of Animal Medicine and Surgery, Veterinary School, University Autonoma of Barcelona, Barcelona, Spain
| | - José Joaquin Ceron
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, Faculty of Veterinary Medicine, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Espinardo, Murcia, Spain.
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Association between total antioxidant capacity and mortality in ischemic stroke patients. Ann Intensive Care 2016; 6:39. [PMID: 27107565 PMCID: PMC4842192 DOI: 10.1186/s13613-016-0143-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/11/2016] [Indexed: 11/10/2022] Open
Abstract
Objective Data on circulating total antioxidant capacity (TAC) levels in ischemic stroke patients compared with healthy controls are limited and provided conflicting findings. There are not data about the association between circulating TAC levels, peroxidation state and outcome in patients with severe ischemic stroke. The objective of this study was to examine the relationship of TAC with 30-day mortality after severe ischemic stroke. Methods This multicenter study included 58 patients with coma (Glasgow Coma Scale < 9) following severe malignant middle cerebral artery infarction (MMCAI). We measured circulating levels of TAC and malondialdehyde (MDA, a biomarker of lipid peroxidation) on day 1 of severe MMCAI diagnosis. The study endpoint was 30-day mortality. Results Non-survivors (n = 29) showed higher serum TAC levels (p < 0.001) and higher serum MDA levels (p = 0.004) than survivors (n = 29). Multiple binomial logistic regression analysis showed that serum TAC levels were associated with 30-day mortality, after controlling for Glasgow Coma Scale and age (odds ratio 1.92; 95 % confidence interval 1.201–3.072; p = 0.006). There was a correlation between serum TAC and MDA levels (rho = 0.35; p = 0.008). Conclusions This single-center study in severe MMCAI patients found an association between higher serum TAC levels and 30-day mortality and further identified a relationship between serum TAC levels, lipid peroxidation state and mortality after severe ischemic stroke.
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Lorente L, Martín MM, Almeida T, Abreu-González P, Ramos L, Argueso M, Riaño-Ruiz M, Solé-Violán J, Jiménez A. Total antioxidant capacity is associated with mortality of patients with severe traumatic brain injury. BMC Neurol 2015. [PMID: 26205136 PMCID: PMC4513627 DOI: 10.1186/s12883-015-0378-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Previously, circulating total antioxidant capacity (TAC) in traumatic brain injury (TBI) patients has been scarcely studied and only in studies of small sample size (lower than 55 TBI patients). In one study were found higher serum TAC in non-survivor than in survivor TBI patients; however, an association between circulating TAC and mortality in patients with TBI has not been previously reported. Thus, the objective of this study was to determine whether there is an association between circulating TAC, peroxidation state and mortality in patients with severe TBI. Methods This was a multicenter, observational and prospective study was carried out in six Spanish Intensive Care Units. We included patients with severe TBI defined as Glasgow Coma Scale (GCS) lower than 9. We excluded patients with Injury Severity Score (ISS) in non-cranial aspects higher than 9. We measured serum TAC on day 1 of TBI. The 30-day mortality was established as endpoint. Results Non-surviving TBI patients (N = 27) showed higher serum TAC (P < 0.001) than survivor ones (N = 73). Logistic regression analyses showed that serum TAC higher than 2.59 nmol/mL were associated with 30-day mortality controlling for APACHE-II and CT classification (OR = 4.40; 95 % CI = 1.14–16.98; P = 0.03), controlling for GCS and age (OR = 5.88; 95 % CI = 1.57–22.06; P = 0.009), and controlling for CT classification and admission abnormal pupils (OR = 3.89; 95 % CI = 1.30–11.61; P = 0.02). There was an association between serum TAC and malondialdehyde (a biomarker of lipid peroxidation) levels (rho = 0.25; p = 0.01), APACHE-II score (rho = 0.23; p = 0.03) and GCS (rho = −0.21; p = 0.04). Conclusions To our knowledge, our series is the largest reporting data on circulating TAC in patients with severe TBI. The most relevant and new findings of our study were that there is an association between circulating TAC and peroxidation state and mortality in patients with severe TBI.
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Affiliation(s)
- Leonardo Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain.
| | - María M Martín
- Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, Santa Cruz de Tenerife, 38010, Spain.
| | - Teresa Almeida
- Unidad de Genética. Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Campus de Anchieta, Avda. Astrofísico Francisco Sánchez s/n, La Laguna, Tenerife, 38071, Spain.
| | - Pedro Abreu-González
- Deparment of Phisiology. Faculty of Medicine, University of the La Laguna, Santa Cruz de Tenerife, Spain.
| | - Luis Ramos
- Intensive Care Unit, Hospital General La Palma, Buenavista de Arriba s/n, Breña Alta, La Palma, 38713, Spain.
| | - Mónica Argueso
- Intensive Care Unit, Hospital Clínico Universitario de Valencia, Avda. Blasco Ibáñez n°17-19, Valencia, 46004, Spain.
| | - Marta Riaño-Ruiz
- Servicio de Bioquímica Clínica, Complejo Hospitalario Universitario Insular Materno-Infantil, Plaza Dr. Pasteur s/n, Las Palmas de Gran Canaria, 35016, Spain.
| | - Jordi Solé-Violán
- Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Barranco de la Ballena s/n, Las Palmas de Gran Canaria, 35010, Spain.
| | - Alejandro Jiménez
- Research Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain.
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Georgiev AV, Thompson ME, Mandalaywala TM, Maestripieri D. Oxidative stress as an indicator of the costs of reproduction among free-ranging rhesus macaques. J Exp Biol 2015; 218:1981-5. [PMID: 25908058 PMCID: PMC4510843 DOI: 10.1242/jeb.121947] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/20/2015] [Indexed: 11/20/2022]
Abstract
Sex differences in longevity may reflect sex-specific costs of intra-sexual competition and reproductive effort. As male rhesus macaques experience greater intrasexual competition and die younger, we predicted that males would experience greater oxidative stress than females and that oxidative stress would reflect sex-specific measures of reproductive effort. Males, relative to females, had higher concentrations of 8-OHdG and malondialdehyde, which are markers of DNA oxidative damage and lipid peroxidation, respectively. Older macaques had lower 8-OHdG levels than younger ones, suggesting that oxidative stress decreases in parallel with known age-related declines in reproductive investment. Among males, a recent period of social instability affected oxidative status: males who attacked others at higher rates had higher 8-OHdG levels. Multiparous lactating females with daughters had higher 8-OHdG levels than those with sons. No differences in antioxidant capacity were found. These results lend initial support for the use of oxidative stress markers to assess trade-offs between reproductive effort and somatic maintenance in primates.
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Affiliation(s)
- Alexander V Georgiev
- Institute for Mind and Biology, The University of Chicago, 940 E 57th St, Chicago, IL 60637, USA
| | - Melissa Emery Thompson
- Department of Anthropology, University of New Mexico, 500 University Blvd NE, Albuquerque, NM 87131, USA
| | - Tara M Mandalaywala
- Institute for Mind and Biology, The University of Chicago, 940 E 57th St, Chicago, IL 60637, USA Department of Psychology, New York University, 6 Washington Place, New York, NY 10003, USA
| | - Dario Maestripieri
- Institute for Mind and Biology, The University of Chicago, 940 E 57th St, Chicago, IL 60637, USA
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