Research Article
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Evaluation of Total Oxidant and Antioxidant Capacities in the Patients with Osteomyelitis

Year 2025, Volume: 22 Issue: 3, 538 - 543, 29.09.2025
https://doi.org/10.35440/hutfd.1551288

Abstract

Background: Osteomyelitis is a progressive disease that occurs due to damage to bone tissue caused by a microorganism through infectious and inflammatory processes. It is believed that free oxygen radicals may play a role in the pathogenesis of osteomyelitis. This study aimed to evaluate total oxidant and total antiox-idant levels in blood samples taken from 30 patients diagnosed with osteomyelitis.
Materials and Methods: Between January 2008 and September 2010, 30 patients diagnosed with osteomy-elitis, either as outpatient sorin patients, were included from the Departments of Infectious Disease and Clinical Microbiology and Orthopedics and Traumatology, along with 30 healthy volunteers without osteo-myelitis. The Total Antioxidant Status (TAS) and Total Oxidant Status (TOS) levels of both the patients and the control group were measured using a fully automated colorimetric method. The Oxidative Stress Index (OSI) was calculated by determining the TOS/TAS ratio. The TAS, TOS, and OSI levels of the patients were compared with the results of healthy individuals.
Results: Among the 30 osteomyelitis cases included in the study, 20 (67.7%) were male. There were no statistically significant differences between the patient and control groups in terms of age, gender, and body mass index (p>0.05). TOS and OSI levels were higher in osteomyelitis patients and lower in the con-trol group, with a significant difference between the groups (p=0.001). Conversely, TAS levels were lower in the osteomyelitis group and higher in the control group (p=0.024).
Conclusions: The results of the study implicated that the patients with osteomyelitis were exposed to a severe oxidative stres and the estimation of TAS, TOS and OSI levels may be used as biochemical parameters to follow up these patients, and also that a supportive treatment with antioxidants may improve osteomye-litis therapy. However, more comprehensive studies with larger populations should be conducted to con-firm this result.

Keywords: Osteomyelitis, TAS, TOS, OSI

References

  • 1. Schmitt SK. Osteomyelitis. Infect Dis Clin North Am. 2017;31(2):325-38.
  • 2. McNally M. Osteomyelitis. In: Chen AF, ed. Management of Orthopaedic Infections A Practical Guide. Thieme. 2021:61-87.
  • 3. Tande AJ, Steckelberg JM, Osman DR, Berbari EF. Osteomyelitis: principle sand practice of infectious diseases. Bennett JE, Dolin R, Blaser MJ, eds.9 ed. Elselvier Churchill Livingstone; 2015:1418-29.
  • 4. Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol. 2001 Mar;54(3):176-86.
  • 5. Savran M, Ozmen O, Erzurumlu Y, Savas HB, Asci S, Kaynak M. The Impact of Prophylactic Lacosamide on LPS-Induced Neu-roinflammation in Aged Rats. Inflammation. 2019;42(5):1913-24.
  • 6. Savran M, Asci H, Ozmen O, Erzurumlu Y, Savas HB, Sonmez Y, et al. Melatonin protects the heart and endothelium against high fructose corn syrup consumption- induced cardiovascular tox-icityvia SIRT-1 signaling. Hum ExpToxicol. 2019;38(10):1212-23.
  • 7. Savran M, Aslankoc R, Ozmen O, Erzurumlu Y, Savas HB, Temel EN, et al. Agomelatine could prevent brain and cerebellum in-jury against LPS-induced neuroinflammation in rats. Cytokine. 2020;20;127:154957.
  • 8. Asci H, Ozmen O, Erzurumlu Y, Savas HB, Temel EN, Icten P, Hasseyid N. Ameliorative effects of pregabalin on LPS induced endothelial and cardiac toxicity. Biotech Histochem. 2021 Jul;96(5):364-375.
  • 9. Ghiselli A, Serafini M, Natella F, Scaccini C. Total antioxidant capacity as a tool to assess redox status: Critical view and ex-perimental data, Free Radic Biol Med, 2000;29(11): 1106-14.
  • 10. Gantt KR, Goldman TL, McCormick ML, Miller MA, Jeronimo SM, Nascimento ET, et al. Oxidative responses of human and murine macrophages during phagocytosis of Leishmania chagasi. J Im-munol. 2001 Jul 15;167(2):893-901.
  • 11. Murray HW, Teitelbaum RF. L-arginine-dependent reactive nitrogen intermediates and the antimicrobial effect of activat-ed human mononuclear phagocytes. J InfectDis. 1992 Mar;165(3):513-7.
  • 12. Erel O. A new automated colorimetric method form easuring total oxidant status. Clin Biochem. 2005; 38(12): 1103-11.
  • 13. Erel O. A novel automated method to measure total antioxi-dant response against potent free radical reactions. Clin Bio chem. 2004;37(2): 112-9.
  • 14. Harma M, Harma M, Erel O. Oxidative stress in women with preeclampsia. Am J Obstet Gynecol. 2005;192: 656-7.
  • 15. Harma M, Harma M, Erel O. Measurement of the total antioxi-dant response in preeclampsia with a novel automated meth-od. Eur J Obstet Gynecol Reprod Biol. 2005 Jan 10;118(1):47-51.
  • 16. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program forth esocial, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91.
  • 17. Massaccesi L, Galliera E, Pellegrini A, Banfi G, Corsi Romanelli MM. Osteomyelitis, Oxidative Stress and Related Biomarkers. Antioxidants (Basel). 2022 May 27;11(6):1061.
  • 18. Agidigbi TS, Kim C. Reactive Oxygen Species in Osteoclast Dif-ferentiation and Possible Pharmaceutical Targets of ROS-Mediated Osteoclast Diseases. Int J Mol Sci. 2019 Jul 22;20(14):3576.
  • 19. Kralova J, Drobek A, Prochazka J, Spoutil F, Fabisik M, Glatzova D, et al. Dysregulated NADPH Oxidase Promotes Bone Damage in Murine Model of Autoinflammatory Osteomyelitis. J Immu-nol. 2020 Mar 15;204(6):1607-20.
  • 20. Grbic R, Miric DJ, Kisic B, Popovic L, Nestorovic V, Vasic A. Sequential analysis of oxidative stress markers and vitamin C status in acute bacterial osteomyelitis. Mediators Inflamm. 2014;2014:975061.
  • 21. Jyoti A, Singh S, Mukhopadhyay B, Gavel R, Mishra SP. Free radicals and antioxidant status in chronic osteomyelitis pa-tients: a case control study. J Clin Diagn Res. 2015 Apr; 9(4):BC08-10.
  • 22. Özkan S, Adanaş C, Demir C, Hakan H. The levels of oxidative DNA damage and some antioxidants in chronic osteomyelitis patients: A cross-sectional study. Int J Clin Pract. 2021 Nov;75(11):e14704.
  • 23. Martusevich AK, Dmitrochenkov AV, Razumovsky AV, Galova EA. Possibilities of monitoring the physical and chemical properties of biological fluids in combustiology. Medicine (Russia). 2018;1:149-160.
  • 24. Martusevich AK, Razumovsky AV, Soloveva AG, Ezhevskaya AA, Peretyiagin SP. The study of postburn metabolic rehabilitation with natural NO donor. Asian Journal of Biochemical and Phar-maceutical Research. 2016;6(3):14-21.
  • 25. Martusevich AK, Zagrekov VI, Belyaeva KL, Pushkin AS, Soloveva AG. Oxidative stres in osteomyelitis and burns: Specific features of its role in development of pathology. Biomedical Research and Therapy 2021;8(3):4286-93.
  • 26. Duygu F, Tekin Koruk S, Aksoy N. Serum paraoxonase and aryles-terase activities in various forms of hepatitis B virus infection. J Clin Lab Anal. 2011;25(5):311-6.
  • 27. Soran N, Altindag O, Cakir H, Celik H, Demirkol A, Aksoy N. Assessment of paraoxonase activities in patients with knee os-teoarthritis. Redox Rep. 2008;13(5):194-8.
  • 28. D’Silva VBS, Kumari SN, Naveen P, Shetty V, Shetty L. A compar-ative study of oxidative stress in diabetic and non-diabetic os-teomyelitis. Research Journal of Pharmaceutical Biological and Chemical Sciences. 2011;2(1):342-7.
  • 29. Tekin Koruk S, Aksoy N, Hamidanoglu M, Karsen H, Unlu S, Bilinc H. The activity of paraoxonase and arylesterase in patients with osteomyelitis. Scand J ClinLabInvest. 2012 Nov;72(7):513-7.
  • 30. Sandukji A, Al-Sawaf H, Mohamadin A, Alrashidi Y, Sheweita SA. Oxidative stress and bone markers in plasma of patients with long-bone fixative surgery: role of antioxidants. Hum Exp Toxi-col. 2011 Jun;30(6):435- 42.
  • 31. Lavery LA, Ahn J, Ryan EC, Bhavan K, Oz OK, La Fontaine J, et al. What are the Optimal Cutoff Values for ESR and CRP to Diag-nose Osteomyelitis in Patients with Diabetes-related Foot In-fections? Clin Orthop Relat Res. 2019 Jul;477(7):1594-1602.
  • 32. Van Asten SA, Nichols A, La Fontaine J, Bhavan K, Peters EJ, Lavery LA. The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis. Int Wound J. 2017 Feb;14(1):40-45.
  • 33. Jha Y, Chaudhary K. Diagnosis and Treatment Modalities for Osteomyelitis. Cureus. 2022 Oct 26;14(10):e30713.
  • 34. Malcius D, Jonkus M, Kuprionis G, Maleckas A, Monastyreckiene E, Uktveris R, et al. The accuracy of different imaging tech-niques in diagnosis of acute hematogenous osteomyelitis. Me-dicina (Kaunas). 2009;45(8):624- 31.
  • 35. Bonhoeffer J, Haeberle B, Schaad UB, Heininger U. Diagnosis of acute haematogenous osteomyelitis and septic arthritis: 20 years experience at the University Children's Hospital Basel. SwissMedWkly. 2001 Oct 6;131(39-40):575-81.
  • 36. Süner A, Polat M, Sezen H, Şavik E, Kaya H, Köroğlu S. Uzun süreli sigara kullanımının oksidatif stres üzerine etkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2014;11(2):138-145.

Osteomiyelitli Hastalarda Oksidan ve Antioksidan Kapasitelerin Değerlendirilmesi

Year 2025, Volume: 22 Issue: 3, 538 - 543, 29.09.2025
https://doi.org/10.35440/hutfd.1551288

Abstract

Amaç: Osteomiyelit; bir mikroorganizmanın infeksiyöz ve inflamatuar süreçler ile kemik dokuda hasar yaratması sonucu ortaya çıkan ilerleyici karakterde bir hastalıktır. Osteomiyelitin patogenezinde serbest oksijen radikallerinin rolü olabileceği düşünülmektedir. Bu çalışmada osteomiyelit tanısı alan 30 hastadan alınan kan örneklerinde total oksidan ve total antioksidan seviyelerin değerlendirilmesi amaçlandı.
Materyal ve Metod: Ocak 2008 ile Eylül 2010 tarihleri arasında Enfeksiyon Hastalıkları ve Klinik Mikrobiy-oloji ile Ortopedi ve Travmatoloji Kliniklerinde ayaktan ve/veya yatarak osteomiyelit tanısı alan 30 hasta ve osteomiyeliti olmayan 30 sağlıklı gönüllü çalışmaya alındı. Hastaların ve kontrol grubunun TAS (Total anti-oksidan seviye) ve TOS (Total oksidan seviye) düzeyleri tam otomatik kolorimetrik yöntemle çalışıldı. TOS/TAS oranı hesaplanarak oksidatif stres indeksi (OSİ) bulundu. Hastaların TAS, TOS ve OSİ düzeyleri sağlıklı kişilerin sonuçları ile kıyaslandı.
Bulgular: Çalışmaya alınan 30 osteomiyelit olgusunun 20’si (%67,7) erkek idi. Hasta ve kontrol grupları arasında yaş, cinsiyet ve beden kitle indeksi ortalaması açısından istatistiksel olarak anlamlı fark yoktu (p>0,05). TOS ve OSİ düzeyleri osteomiyelitli hastalarda yüksek, kontrol grubunda ise düşüktü ve gruplar arasında anlamlı fark vardı (p=0,001). TAS düzeyi ise osteomiyelitli hasta grubunda düşük, kontrol grubunda yüksekti (p=0,024).
Sonuç: Çalışma sonuçları osteomiyelitli hastaların şiddetli oksidatif strese maruz kaldıklarını, TAS, TOS ve OSİ seviye ölçümlerinin bu hastaların takibinde kullanılabilecek biyokimyasal parametreler olduğunu ve ayrıca tedaviye destekleyici olarak antioksidanların eklenmesi ile gelişme sağlanabileceğini düşündürmektedir. Ancak bu sonucu teyit edebilmek için daha geniş popülasyonlarla daha kapsamlı yapılacak çalışmalara gerek vardır.

Ethical Statement

Bu çalışma tezden üretilmiştir. Çalışma için Şanlıurfa Klinik Araştırmalar Etik Kurul Başkanlığı’ndan onay alınmıştır (09.12.2009 tarih ve 2009.12.03 sayılı karar).

References

  • 1. Schmitt SK. Osteomyelitis. Infect Dis Clin North Am. 2017;31(2):325-38.
  • 2. McNally M. Osteomyelitis. In: Chen AF, ed. Management of Orthopaedic Infections A Practical Guide. Thieme. 2021:61-87.
  • 3. Tande AJ, Steckelberg JM, Osman DR, Berbari EF. Osteomyelitis: principle sand practice of infectious diseases. Bennett JE, Dolin R, Blaser MJ, eds.9 ed. Elselvier Churchill Livingstone; 2015:1418-29.
  • 4. Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol. 2001 Mar;54(3):176-86.
  • 5. Savran M, Ozmen O, Erzurumlu Y, Savas HB, Asci S, Kaynak M. The Impact of Prophylactic Lacosamide on LPS-Induced Neu-roinflammation in Aged Rats. Inflammation. 2019;42(5):1913-24.
  • 6. Savran M, Asci H, Ozmen O, Erzurumlu Y, Savas HB, Sonmez Y, et al. Melatonin protects the heart and endothelium against high fructose corn syrup consumption- induced cardiovascular tox-icityvia SIRT-1 signaling. Hum ExpToxicol. 2019;38(10):1212-23.
  • 7. Savran M, Aslankoc R, Ozmen O, Erzurumlu Y, Savas HB, Temel EN, et al. Agomelatine could prevent brain and cerebellum in-jury against LPS-induced neuroinflammation in rats. Cytokine. 2020;20;127:154957.
  • 8. Asci H, Ozmen O, Erzurumlu Y, Savas HB, Temel EN, Icten P, Hasseyid N. Ameliorative effects of pregabalin on LPS induced endothelial and cardiac toxicity. Biotech Histochem. 2021 Jul;96(5):364-375.
  • 9. Ghiselli A, Serafini M, Natella F, Scaccini C. Total antioxidant capacity as a tool to assess redox status: Critical view and ex-perimental data, Free Radic Biol Med, 2000;29(11): 1106-14.
  • 10. Gantt KR, Goldman TL, McCormick ML, Miller MA, Jeronimo SM, Nascimento ET, et al. Oxidative responses of human and murine macrophages during phagocytosis of Leishmania chagasi. J Im-munol. 2001 Jul 15;167(2):893-901.
  • 11. Murray HW, Teitelbaum RF. L-arginine-dependent reactive nitrogen intermediates and the antimicrobial effect of activat-ed human mononuclear phagocytes. J InfectDis. 1992 Mar;165(3):513-7.
  • 12. Erel O. A new automated colorimetric method form easuring total oxidant status. Clin Biochem. 2005; 38(12): 1103-11.
  • 13. Erel O. A novel automated method to measure total antioxi-dant response against potent free radical reactions. Clin Bio chem. 2004;37(2): 112-9.
  • 14. Harma M, Harma M, Erel O. Oxidative stress in women with preeclampsia. Am J Obstet Gynecol. 2005;192: 656-7.
  • 15. Harma M, Harma M, Erel O. Measurement of the total antioxi-dant response in preeclampsia with a novel automated meth-od. Eur J Obstet Gynecol Reprod Biol. 2005 Jan 10;118(1):47-51.
  • 16. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program forth esocial, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91.
  • 17. Massaccesi L, Galliera E, Pellegrini A, Banfi G, Corsi Romanelli MM. Osteomyelitis, Oxidative Stress and Related Biomarkers. Antioxidants (Basel). 2022 May 27;11(6):1061.
  • 18. Agidigbi TS, Kim C. Reactive Oxygen Species in Osteoclast Dif-ferentiation and Possible Pharmaceutical Targets of ROS-Mediated Osteoclast Diseases. Int J Mol Sci. 2019 Jul 22;20(14):3576.
  • 19. Kralova J, Drobek A, Prochazka J, Spoutil F, Fabisik M, Glatzova D, et al. Dysregulated NADPH Oxidase Promotes Bone Damage in Murine Model of Autoinflammatory Osteomyelitis. J Immu-nol. 2020 Mar 15;204(6):1607-20.
  • 20. Grbic R, Miric DJ, Kisic B, Popovic L, Nestorovic V, Vasic A. Sequential analysis of oxidative stress markers and vitamin C status in acute bacterial osteomyelitis. Mediators Inflamm. 2014;2014:975061.
  • 21. Jyoti A, Singh S, Mukhopadhyay B, Gavel R, Mishra SP. Free radicals and antioxidant status in chronic osteomyelitis pa-tients: a case control study. J Clin Diagn Res. 2015 Apr; 9(4):BC08-10.
  • 22. Özkan S, Adanaş C, Demir C, Hakan H. The levels of oxidative DNA damage and some antioxidants in chronic osteomyelitis patients: A cross-sectional study. Int J Clin Pract. 2021 Nov;75(11):e14704.
  • 23. Martusevich AK, Dmitrochenkov AV, Razumovsky AV, Galova EA. Possibilities of monitoring the physical and chemical properties of biological fluids in combustiology. Medicine (Russia). 2018;1:149-160.
  • 24. Martusevich AK, Razumovsky AV, Soloveva AG, Ezhevskaya AA, Peretyiagin SP. The study of postburn metabolic rehabilitation with natural NO donor. Asian Journal of Biochemical and Phar-maceutical Research. 2016;6(3):14-21.
  • 25. Martusevich AK, Zagrekov VI, Belyaeva KL, Pushkin AS, Soloveva AG. Oxidative stres in osteomyelitis and burns: Specific features of its role in development of pathology. Biomedical Research and Therapy 2021;8(3):4286-93.
  • 26. Duygu F, Tekin Koruk S, Aksoy N. Serum paraoxonase and aryles-terase activities in various forms of hepatitis B virus infection. J Clin Lab Anal. 2011;25(5):311-6.
  • 27. Soran N, Altindag O, Cakir H, Celik H, Demirkol A, Aksoy N. Assessment of paraoxonase activities in patients with knee os-teoarthritis. Redox Rep. 2008;13(5):194-8.
  • 28. D’Silva VBS, Kumari SN, Naveen P, Shetty V, Shetty L. A compar-ative study of oxidative stress in diabetic and non-diabetic os-teomyelitis. Research Journal of Pharmaceutical Biological and Chemical Sciences. 2011;2(1):342-7.
  • 29. Tekin Koruk S, Aksoy N, Hamidanoglu M, Karsen H, Unlu S, Bilinc H. The activity of paraoxonase and arylesterase in patients with osteomyelitis. Scand J ClinLabInvest. 2012 Nov;72(7):513-7.
  • 30. Sandukji A, Al-Sawaf H, Mohamadin A, Alrashidi Y, Sheweita SA. Oxidative stress and bone markers in plasma of patients with long-bone fixative surgery: role of antioxidants. Hum Exp Toxi-col. 2011 Jun;30(6):435- 42.
  • 31. Lavery LA, Ahn J, Ryan EC, Bhavan K, Oz OK, La Fontaine J, et al. What are the Optimal Cutoff Values for ESR and CRP to Diag-nose Osteomyelitis in Patients with Diabetes-related Foot In-fections? Clin Orthop Relat Res. 2019 Jul;477(7):1594-1602.
  • 32. Van Asten SA, Nichols A, La Fontaine J, Bhavan K, Peters EJ, Lavery LA. The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis. Int Wound J. 2017 Feb;14(1):40-45.
  • 33. Jha Y, Chaudhary K. Diagnosis and Treatment Modalities for Osteomyelitis. Cureus. 2022 Oct 26;14(10):e30713.
  • 34. Malcius D, Jonkus M, Kuprionis G, Maleckas A, Monastyreckiene E, Uktveris R, et al. The accuracy of different imaging tech-niques in diagnosis of acute hematogenous osteomyelitis. Me-dicina (Kaunas). 2009;45(8):624- 31.
  • 35. Bonhoeffer J, Haeberle B, Schaad UB, Heininger U. Diagnosis of acute haematogenous osteomyelitis and septic arthritis: 20 years experience at the University Children's Hospital Basel. SwissMedWkly. 2001 Oct 6;131(39-40):575-81.
  • 36. Süner A, Polat M, Sezen H, Şavik E, Kaya H, Köroğlu S. Uzun süreli sigara kullanımının oksidatif stres üzerine etkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2014;11(2):138-145.
There are 36 citations in total.

Details

Primary Language Turkish
Subjects Infectious Diseases
Journal Section Research Article
Authors

Melek Hamidanoğlu 0000-0001-7222-8352

Süda Tekin 0000-0001-9419-8713

Nurten Aksoy 0000-0002-5425-0975

Early Pub Date September 10, 2025
Publication Date September 29, 2025
Submission Date September 16, 2024
Acceptance Date July 7, 2025
Published in Issue Year 2025 Volume: 22 Issue: 3

Cite

Vancouver Hamidanoğlu M, Tekin S, Aksoy N. Osteomiyelitli Hastalarda Oksidan ve Antioksidan Kapasitelerin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(3):538-43.

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