OXIDATIVE STRESS AND ANTIOXIDANT STATUS IN BRONCHOALVEOLAR LAVAGE FLUID, PLASMA AND ERYTHROCYTE OF CRITICALLY MIXED ILL WITH RESPIRATORY FAILURE

Öz

-

Anahtar Kelimeler

• -

OXIDATIVE STRESS AND ANTIOXIDANT STATUS IN BRONCHOALVEOLAR LAVAGE FLUID, PLASMA AND ERYTHROCYTE OF CRITICALLY MIXED ILL WITH RESPIRATORY FAILURE

Abstract

Aim: Increased oxidative stress is a significant part of pathogenesis of various lung diseases. In this trial, it is aimed to determine the role of oxidative stress in patients receiving mechanical ventilation for respiratory failure (RF). Methods: The oxidative stress was evaluated by determining plasma, bronchial fluid and erythrocyte levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), ascorbic acid, alpha-tocopherol, uric acid (UA) and nitric oxide (NO) in 25 critically ill patients with RF. Twenty five patients without RF was evaluated as control group. Results: Oxidative stress (MDA, NO) levels of plasma, erythrocyte and BAL fluid in mixed critically ill with respiratory failure were higher than control group. Antioxidant levels of plasma, erythrocyte and BAL fluid in mixed critically ill with respiratory failure were lower than control group. In all parameters, there was no statistically difference as exitus and survivors in critically mixed patients. Conclusion: Oxidative stress was higher in respiratory failure than control group. The aim of the present study was to investigate the status of oxidative stress and antioxidant in mixed critically ill patients with respiratory failure as assessed by the malondialdehyde (MDA), NO, SOD, GSH-Px, vit C, vit E and uric acid measurements in bronchoalveolar lavage (BAL), erythrocyte and plasma.MATERIALS AND METHODS A total 50 subjects were examined, 25 with respiratory failure (average 65.6±12.7 years, 17 males and 8 females) and 25 patients without respiratory failure (average 55.4±9.36 years, 19 males and 6 females). The patients Table 1. Characteristics of patients and control groupMixed critically ill patients

Keywords

• Respiratory failure, oxidative stress, antioxidant status

References

1. Kinnula VL, Crapo JD. Superoxide dismutases in the lung and human lung diseases. Am J Respir Crit Care Med 2003;167:1600-1619
2. Halliwell B, Gutteridge JMC. Free radicals in biology and medicine, 3rd ed. Oxford: Oxford University Press; 1999
3. Bowler RP, Crapo JD. Oxidative stress in airways; is there a role for extracellular superoxide dismutase. Am J Respir Crit Care Med 2002;166:S38-S43
4. Rahman I, Biswas SK, Kode A. Oxidant and antioxidant balance in the airways and airway diseases. Eur J Pharma 2006;533:222-239
5. Gutteridge JM, Mitchell J. Redox imbalance in the critically ill. Br Med Bull 1999;55:49- 75
6. Oldham KM, Bowen EP. Oxidative stress in critical care: is antioxidant supplementation beneficial. J Am Diet Assoc 1998;98:1001- 1008
7. Sokolowsly JW, Burgher LW, Jones FL, Patterson JR, Selecky PA. Guidelines for fiberoptic bronchoscopy in adults. Am Rev Respir Dis 1987;136:1066
8. Wasowicz W, Neve S, Peretz A: Optimized steps in fluorometric determination of thiobarbituric in serum: Importance of extraction pH and influence of sample preservation and storage. Clin Chem 1993; 39:2522-2526.

9. Sun Y, Oberley LW, Ying L:A simple method for clinical assay of superoxide dismutase. Clin Chem 1988; 34:497-500.
10. Paglia DE, Valentine WN. Studies on the quantitative and qualitative characterisation of erythrocyte glutathione peroxidase. J Lab & Clin Med 1967; 70:158-169.
11. Hashim SA, Schuttringer GR. Rapid determination of tocopherol in marco- and microquantities of plasma. Results obtained in various nutrition and metabolic studies. Am J Clin Nutr. 1966;19(2):137-45.
12. Omaye ST, Skala JH, Jacob RA. Plasma ascorbic acid in adult males: effects of depletion and supplementation. Am J Clin Nutr. 1986;44(2):257-64.
13. Geoghegan M, McAuley D, Eaton S, Powell- Tuck J. Selenium in critical illness. Curr Opin Crit Care 2006;12:136-141
14. Gutteridge JM, Mitchell J. Redox imbalance in critically ill. Br Med Bull 1999;55:49-75
15. Motoyama T, Okamoto K, Kukita I et al. Possible role of increased oxidant stress in multiple organ failure after systemic inflammatory response syndrome. Crit Care Med 2003;31:1048-52
16. Bela P, Bahl R, Sane AS et al. Oxidative stress status: possible guideline for clinical management of critically ill patients. Panminerva Med 2001;43(1):27-31
17. Alonso de Vega JM, Diaz J, Serrano E, Carbonell LF. Plasma redox status relates to severity in critically ill patients. Crit Care Med 2000;28:1812-4
18. Mulligan MS, Hevel JM, Marletta MA et al. Tissue injury caused by deposition of immune complex is L-arginine dependent. Proc Natl Acad Sci USA 1991;88:6338-42
19. Sittipunt C, Steinberg KP, Ruzinski JT et al. Nitric oxide and nitrotyrosine in the lungs of patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2001;163:503-10
20. Taylor DE, Ghio AJ, Piantadosi CA. Reactive oxygen species produced by liver mitochondria of rats in sepsis. Arch Biochem Biophys 1995; 316:70-6
21. Strand OA, Leone A, Giercksky KE et al. Nitric oxide indices in human septic shock. Crit Care Med 2000;28:2779-85
22. Dhillon SS, Mahadevan K, Bandi V, Zheng Z, Smith W, Rumbaut RE. Neutrophils, nitric oxide, and microvascular permeability in severe sepsis. Chest 2005;128:1706-12
23. Halliwell B, Gutteridge JM. The antioxidants of human extracellular fluids. Arch Biochem Biophys 1990;280:1-8
24. Wendel A. Enzymatic basis of detoxification. Vol.1 New York: Academic Press, 1980. pp. 333-53
25. Therond P, Bonnefont-Rousselot D, Davit- Spraul A, Conti M, Legrand A. Biomarkers of oxidative stress: an analytical approach. Curr Opin Clin Nutr Metab Care 2000;3:373- 84
26. Metnitz PGH, Bartens C, Fischer M, Fridrich P, Steltzer H, Druml W. Antioxidant status in patients acute respiratory distress syndrome. Intensive Care Med 1999;25:180-5
27. Flaring UB Rooyackers OE, Hebert C, Bratel T, Hammarqvist F, Wernerman J. Temporal changes in whole-blood and plasma glutathione in ICU patients with multiple organ failure. Intensive Care Med 2005;31(8): 1072-8
28. Cros CE, Forte T, Stocker R, et al. Oxidative stress and abnormal cholesterol metabolism in patients with adult respiratory distress syndrome. J Lab Clin Med 1990;115:396-404
29. Schorah CJ, Downing C, Pripitsi A, Gallivan L, Al-Hazaa A, Sanderson MJ, Bodenham A. Total vitamin C, ascorbic acid and dehydroascorbic acid concentrations in plasma of critically ill patients. Am J Clin Nutr 1996;63:760-5
30. Pacht ER, Timerman AP, Lykens MG, et al. Deficiency of alveolar fluid glutathione in patients with sepsis and the adult respiratory distress syndrome. Chest 1991;100:1397- 403
31. Leff JA, Parsons PE, Day CE, et al. Increased serum catalase activity in septic patients with the adult respiratory distress syndrome. AM Rev Respir Dis 1992;146:985-9