The effect of slow-release vaginal dinoprostone on maternal and fetal oxidative stress in term pregnancies complicated by oligohydramnios: Prospective cohort study

BACKGROUND

To evaluate changes in oxidant status using thiol/disulfide homeostasis in mothers and fetuses after induction of labor with slow-release vaginal dinoprostone inserts.

METHODS

A total of 70 pregnant women were divided into two groups. Thirty-five women in whom labor was induced with slow-release vaginal dinoprostone inserts (10 mg of prostaglandin E2, group A) were compared before and after the administration. The other 35 women, who were followed up spontaneously during labor (group B), were included as a control group. Both groups were diagnosed with isolated oligohydramnios without signs of placental insufficiency. The thiol/disulfide homeostasis parameters were calculated before medical induction and after removal of the insert at the beginning of the active phase of labor. Maternal and cord blood values were measured in both groups.

RESULTS

Although the balance shifted to the antioxidant side after the slow-release vaginal dinoprostone insert was applied, there was no significant difference in maternal oxidative load compared to the pre-application status (5.32 ± 014/5.16 ± 0.15, p = 0.491). Despite the shift toward the antioxidant side, maternal antioxidants were still significantly lower in the group that received slow-release vaginal dinoprostone at the beginning of the active phase of labor than in the control group (295.98 ± 13.03/346.47 ± 12.04, respectively, p = 0.009). There was no statistically significant difference in terms of oxidative balance or newborn Apgar score ( p > 0.05).

CONCLUSION

Induction of labor with slow-release vaginal dinoprostone inserts in pregnancies with isolated oligohydramnios does not cause further oxidative stress and is safe for both mothers and neonates in terms of oxidant load by thiol/disulfide homeostasis.

A comprehensive review of novel biomarkers in the diagnosis of intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a disease specific to pregnancy, featuring maternal itching and elevated serum bile acid levels. It leads to a series of adverse pregnancy outcomes as well as increased fetal mortality. Routine biochemical markers fail to fulfill the tremendous clinical requirements, thereby novel effective biomarkers are urgently desired. In our review, the potential novel biomarkers for ICP diagnosis are classified into four categories and elaborated in detail. The concrete diagnostic performances (sensitivity, specificity and area under the curve) of these biomarkers are demonstrated in tables. Moreover, the relationships between some biomarkers and ICP pathogenesis are briefly expounded. Nevertheless, only a few novel biomarkers are ideal, and their clinical applicability requires more evidence from larger multicenter trials.

Maternal Epilepsy and Umbilical Cord Blood Oxidative Stress Level

INTRODUCTION

We investigated the effect of epilepsy on cord blood oxidative stress status.

MATERIAL AND METHODS

Thirty (n = 30) pregnant women with epilepsy and thirty (n = 30) healthy controls enrolled in this case control study. Albumin and IMA values and dynamic thiol/disulfide parameters were measured.

RESULTS

Decreased native thiol and total thiol levels were found in the epilepsy group when compared to the control group (p: 0.001, p: 0.002). Higher IMA (p: 0.036) and lower albumin cord levels (P < 0.001) were measured in the epilepsy group with respect to the control group. Apgar scores at 1 and 5 miutes were lower in the epilepsy group (respectively; p = 0.012, p = 0.010). A negative correlation was found between IMA and cord pH value (r = 0.288 p = 0.034).

CONCLUSION

This study showed that epilepsy may alter thiol disulfide homeostasis and IMA levels.

Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross-sectional, case-control study

Objective:

In this study, we examined the serum hematologic and lipid parameters of pregnant women with preeclampsia and an age- and gestational-age matched normotensive control group. We also compared the ratios of hemato-lipid parameters defined as systemic inflammatory markers and determined the predictive value of these values in preeclampsia.

Materials and Methods:

All patients diagnosed with late-onset preeclampsia or severe preeclampsia between 34 and 40 weeks of gestation at Inonu University Faculty of Medicine between March 2019 and October 2020 were included.

Results:

A total of 253 pregnant women were included in the study period. When the study groups were compared in terms of hematological and blood lipid profile; while serum lymphocyte, triglyceride, and total cholesterol levels were significantly higher in the preeclampsia group than in the control group (p<0.001, p<0.001, p=0.013, respectively); high-density lipoprotein (HDL)-cholesterol levels were found to be significantly lower (p=0.017). The cut-off value for the monocyte/HDL ratio in predicting severe preeclampsia was 16.65 with 59.0% sensitivity and 85.4% specificity [the area under the receiver operating characteristic 0.756, 95% confidence interval (CI) 0.681-0.821, p<0.001]. Multivariate analysis showed that the monocyte/HDL ratio was independently associated with both preeclampsia and severe preeclampsia [odds ratio (OR): 1.094; 95% CI 1.009-1.185 and OR: 1.731; 95% CI 1.218-2.459, respectively].

Conclusion:

This study demonstrated that serum triglyceride and total cholesterol levels were significantly higher and serum HDL-cholesterol levels were significantly lower in pregnant women with late-onset preeclampsia compared to normotensive pregnant women. Additionally, this study revealed that the measurement of monocyte/HDL ratio in the pregnant population could be a useful clinical tool for predicting preeclampsia.

The relationship between serum thiol levels and thiol/disulfide homeostasis in women with tubal ectopic pregnancy

OBJECTIVE

The aim of this study was to investigate the thiol/disulfide homeostasis in tubal ectopic pregnancies in terms of early diagnosis of the disease.

DESIGN

A prospective case-control study was carried out between June 2017-February 2018 in the Gynaecology Department of Umraniye Medical and Research Hospital.

MATERIALS AND METHODS

A total of 42 women with ectopic pregnancy were compared with 44 healthy women who have intrauterine first trimester pregnancies. The thiol/disulfide homeostasis is evaluated with the spectrophotometric measurement method that was recently developed by Erel&Neselioglu.

RESULTS

Disulfide/native thiol and disulfide/total thiol ratios were increased (p = 0.018 and p = 0.023 respectively), while native thiol/total thiol ratios and native thiol levels were decreased in tubal ectopic pregnancy group according to control group (p = 0.023). Between control and tubal ectopic pregnancy groups no differences were measured in disulfide levels (p = 0.350). The area under curve for native thiol and total thiol were 0.937 and 0.927, respectively. The optimum cut off value for native thiol was 379.95 μmol/l with a sensitivity of 90% and specificity of 81%. The optimum cut off value for total thiol was 432.5 μmol/l had 92% sensitivity and 79% specificity.

LIMITATIONS

In the study, whether intrauterine pregnancies resulted in miscarriage or delivery can be examined.

CONCLUSION

Increased disulfide/native thiol levels, disulfide/total-thiol ratio and decreased native/total thiol ratio were found to be significantly associated with the presence of tubal ectopic pregnancy which can be useful for the early diagnosis of the disease.

Thiol-disulfide homeostasis: an integrated approach with biochemical and clinical aspects

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.

Evaluation of thiol/disulfide homeostasis in patients with gestational diabetes mellitus

This study aimed to study the dynamic thiol/disulfide homeostasis in pregnant women with gestational diabetes mellitus (GDM). Forty-five pregnant women with GDM and 45 age-matched healthy pregnancies were included in this study. Thiol/disulfide homeostasis was measured using a commercial kit (Rel Assay Diagnostics). The patients with GDM had significantly higher disulfide concentrations than healthy pregnant patients (p = .001). Besides, the GDM group had significantly higher disulfide/total thiol, disüplhide/native thiol, and native thiol/total thiol ratio than healthy pregnant patients (p = .001, p = .001 and p = .001, respectively). The significantly higher concentrations of disulfide, disulfide/total thiol, disüplhide/native thiol, and native thiol/total thiol ratio in women with GDM could be considered as the increased oxidative stress.

Thiol/Disulfide Homeostasis in Patients with Molar Pregnancies

Introduction: We aimed to investigate serum dynamic thiol and disulfide levels in patients with molar pregnancy (MP), and compare these concentrations with those of healthy pregnant women. Materials and Methods: Forty-one patients who were diagnosed with MP and 41 gestational age-matched healthy pregnant women were included in this prospective study. MP cases were separated in two groups as complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM). Demographic features and thiol/disulfide homeostasis were recorded for each woman. Results: There was a significant correlation between the decrease in the total thiol and native thiol levels in MP patients. However, no significant difference was observed between CHM and PHM groups in terms of serum disulfide levels. Conclusion: OS is increased in MPs both in complete and partial moles, as determined by thiol/disulfide analysis.

Effects of the anesthesia technique used during cesarean section on maternal-neonatal thiol disulfide homeostasis

BACKGROUND

Thiols are organic compounds consisting of a sulfhydryl group which exerts antioxidant effects via dynamic thiol-disulfide homeostasis (TDH). The shift towards the disulfide states signals an oxidative situation. Maternal-neonatal oxidative stress can be affected by the anesthetic technique used during cesarean section. This study aimed to evaluate the relationship between the type of anesthesia used and the maternal-neonatal TDH.

METHODS

ASA I-II, term parturients undergoing elective cesarean section either under general (Group G) or spinal (Group S) anesthesia were included. Blood specimens were collected preoperatively and postoperatively from the mothers and from the umbilical venous cords at delivery. TDH was studied by a new method developed by the authors (O.E. and S.N.).

RESULTS

Postoperative mother's native thiol, total thiol, disulfide/total thiol, native thiol/ disulfide and disulfide levels were higher in Group G than in Group S. There was no significant difference between the groups in umbilical venous cord albumin, native thiol/total thiol, disulfide, native thiol/ disulfide and total thiol/ disulfide. However, in Group G, umbilical venous cord native thiol and total thiol levels were statistically significantly lower than those in Group S.

CONCLUSIONS

Our results showed that general anesthesia in cesarean section leads to an impairment in TDH when compared with spinal anesthesia. Oxidative stress might be modified by the preferred anesthetic technique.

Serum ischemia modified albumin level and its relationship with the thiol/disulfide balance in placenta percreta patients

The pathogenesis of placenta percreta (PP) is not very well known. This study was designed to analyse the oxidative stress (OS), the thiol/disulphide balance, and ischaemia-modified albumin (IMA) the women with PP. The study included 38 pregnant women with PP and 40 similarly aged healthy pregnant women in their third trimester of gestation. We measured the IMA, native and total thiols, and disulphide concentrations in the maternal sera of all of the participating women. The IMA levels were higher and the native and total thiols were lower in the PP group than in the control group. However, there was no statistical significance with respect to the thiol/disulphide balance between the two groups. The results of this study suggest that an increase in the ischaemia and OS and a decrease in the antioxidant status may contribute to the pathogenesis of PP. Impact statement What is already known on this subject? Placenta percreta (PP) is a serious complication of pregnancy. Although there are several studies investigating the pathophysiological mechanism of PP, whether the pathology results from a lack of decidua or from the over-invasiveness of trophoblasts remains controversial. The pathology of PP is poorly understood. What do the results of this study add? This prospective study has shown an increased ischaemia modified albumin (IMA) and a decreased antioxidant capacity in the patients with placenta percreta. The results from 38 women with PP suggest that the serum concentrations of IMA and the oxidative stress parameters may be able to predict PP in cases of uncertainty. What are the implications of these findings for clinical practice and/or further research? The implication of these findings shed light on understanding the pathogenesis of PP for further research.

The Effect of the 50 g Glucose Challenge Test on The Thiol/Disulfide Homeostasis in Pregnancy

AIM

A 50 g glucose challenge test (GCT) is recommended for screening all pregnant women for gestational diabetes mellitus. In this study, the effect of GCT on the thiol/disulfide balance was investigated.

METHODS

One-hundred women that underwent a 50 g GCT at 24-28 weeks of gestation (63 positive and 37 negative results) were evaluated in terms of thiol/disulfide in serum samples at test hours 0 and 1.

RESULTS

Compared to the baseline values (hour 0), after the glucose load (hour 1), the thiol and native thiol/total thiol (p < 0.0001) of the GCT-positive women were reduced whereas the values of glucose, disulfide, disulfide/native thiol, disulfide/total thiol (p < 0.0001) and total thiol increased (p = 0.018).

CONCLUSION

In GCT-positive pregnant individuals, the glucose load increases oxidative stress by changing the thiol/disulfide homeostasis. Such an effect is not observed in healthy pregnancies.

The change in serum Thiol/Disulphide homeostasis after transrectal ultrasound guided prostate biopsy

Objectives

The aim of this prospective clinical study was to investigate variations in a novel oxidative stress marker (thiol/disulphide homeostasis) in men who underwent transrectal ultrasound guided prostate biopsy (TRUSB).

Materials and Methods

A total of 22 men undergoing TRUSB of the prostate were enrolled in the study. Patients with abnormal digital rectal examination and/or total prostate specific antigen (PSA) over 4ng/mL underwent TRUSB with 12 cores. Serum samples were obtained before and just after the procedure to evaluate the possible changes in thiol/disulphide homeostasis. Mean age, total PSA and free PSA, prostate volume and histopathological data were also recorded.

Results

Mean age of the study population was 65.05±8.89 years. Significant decreases in native and total thiol levels were documented after the biopsy procedure. However, serum disulphide levels and disulphide/native thiol, disulphide/total thiol and native/total thiol ratios did not significantly change after TRUSB. No correlation was observed between oxidative parameters and total PSA and free PSA levels, prostate volume and histopathology of the prostate. However, mean patient age was significantly correlated with mean native and total thiol levels.

Conclusion

Significant decreases in serum native and total thiol levels related to the prostate biopsy procedure suggest that TRUSB causes acute oxidative stress in the human body. Since our trial is the first in the current literature to investigate these oxidative stress markers in urology practice, additional studies are warranted.

Thiol/disulfide parameters as a novel oxidative marker in medical labor induction with oxytocin

BACKGROUND

The aim of this study was to analyze the alterations in thiol levels among mothers and neonates who were prone to medical oxytocin induction.

MATERIALS AND METHODS

A total of 40 pregnant women who underwent medical labor induction with oxytocin (Group A) were compared with 53 women whose labor progressed spontaneously without any kind of induction (Group B). We measured the thiol/disulfide homeostasis parameters (native thiol, total thiol, disulfide, disulfide/total thiol, disulfide/native thiol) of maternal and cord blood.

RESULTS

There were no statistically significant differences with respect to the maternal and cord blood thiol/disulfide homeostasis between the two groups.

CONCLUSION

Being an artificial intervention during labor, oxytocin induction has been found to be safe in terms of oxidative stress (OS) according to the results of this study. Both the maternal and the fetal sides were safe in this molecular manner against oxytocin infusion.

A novel method for determining the relation between nasal polyposis and oxidative stress: the thiol/disulphide homeostasis

CONCLUSION

It is thought that oxidative stress may be the major cause of the increase in the oxide thiol form in the study group. The relationship between oxidative stress status and dynamic thiol/disulphide in nasal polyposis now needs to be investigated.

OBJECTIVES

The purpose of this study was to evaluate the relation between nasal polyposis and thiol/disulphide homeostasis, used as a marker of oxidative stress, by measuring that exchange using a novel technique.

MATERIALS AND METHODS

The study group consisted of 40 patients (mean age = 46.75 ± 13.92 years) with bilateral nasal polyposis patients admitted to the hospital. The control group consisted of 31 (mean age = 43.20 ± 5.68 years) age, sex, and body mass index matched healthy subjects. Thiol/disulphide homeostasis concentrations were measured using a newly-developed method (Erel & Neselioglu).

RESULTS

Native thiol and total thiol levels were lower in the study group compared to the control group (native thiol = 415.8 ± 69.1 μmol/L vs 448.7 ± 37.5 μmol/L, p < 0.05; total thiol = 449.02 ± 72.0 μmol/L vs 477.28 ± 44.5 μmol/L, p < 0.05, respectively). Disulphide level and the disulphide/native thiol and disulphide/total thiol ratios were higher in the study group compared to the control group (disulphide = 16.58 ± 5.04 μmol/L vs 14.28 ± 5.3 μmol/L, p < 0.05; disulphide/native thiol ratio = 4.07 ± 1.52% vs 3.14 ± 1.04%, p < 0.05, disulphide/total thiol ratio = 3.73 ± 1.23% vs 2.94 ± 0.92%, p < 0.05, respectively).

Thiol/disulfide homeostasis in patients with ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory disease. In many inflammatory diseases, increased production of pro-inflammatory cytokines is associated with an increase in oxidative stress mediators. Thiol/disulfide homeostasis is a marker for oxidative stress. The aim of this study was to examine the dynamic thiol/disulfide homeostasis in AS. Sixty-nine patients with AS and 60 age- and sex-matched controls were included in the study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and visual analogue scale (VAS) were used to determine the disease activity. Native thiol, total thiol, and disulfide levels were measured with a novel automated method recently described by Erel and Neselioglu. The aforementioned method is also optionally manual spectrophotometric assay. The total thiol levels were significantly lower in the AS group compared with the control group (p = 0.03). When the patients were divided into active (n = 35) and inactive (n = 34) subgroups using BASDAI scores, the native plasma thiol and total thiol levels were significantly lower in the active AS patients compared to the inactive AS patients (p = 0.02, p = 0.03 respectively). There was a negative correlation between the plasma native thiol levels and VAS, BASDAI scores. Thiol/disulfide homeostasis may be used for elucidating the effects of oxidative stress in AS. Understanding the role of thiol/disulfide homeostasis in AS might provide new therapeutic intervention strategies for patients.