Relation of Antioxidant Native Thiol Level with Inflammatory Markers and Disease Activity Index in Pediatric Ulcerative Colitis

Year 2023, Volume: 17 Issue: 4, 309 - 314, 25.07.2023

Selim Dereci Fatih Duran Salim Neselioglu Burcu Hıdımoglu Duygu İskender Mazman Aysel Ünlüsoy Aksu Arzu Meltem Demir Özcan Erel Samil Hizli

https://doi.org/10.12956/tchd.1260388

Abstract

Objective: Pediatric ulcerative colitis (PUC) is an inflammatory disease. PUC pathogenesis is associated with an imbalance between reactive oxygen species and antioxidant activity which creates oxidative stress. Native thiol (NT) level is antioxidant capacity which is practical and repeatable marker of inflammation and antioxidan level. We aimed to analyse the relation of NT level with inflammatory markers and pediatric ulcerative colitis activity index (PUCAI).

Material and Methods: Thirty-eight PUC patients (SG) and 33 control group (CG) participants were included in the study. PUC patients grouped as in remission, mild, moderate and severe activity according to disease activity according to PUCAI. NT, hemoglobin (Hb), white blood cell (WBC), platelet (PLT), mean platelet volume (MPV), albumin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin 6 (IL-6) levels of all participants were measured at the time they were enrolled in the study and recorded.

Results: Mean age and gender ratio of groups were similar (p>0.050). NT level of SG statistically high compared to CG (p=0.001). Hb, PLT, MPV, CRP, ESR, IL-6 levels of SG were statistically different than CG (p=0.045, p=0.026, p=0.001, p=0.001, p=0.001, p=0.001). NT level of SG was positively correlated with Hb, MPV, albumin (p=0.001, for all). NT level of SG was negatively correlated with PLT, CRP, ESR, IL-6 and PUCAI (p=0.001).

Conclusion: NT level of PUC is significantly lower than CG. NT level of SG was positively correlated with albumin which is a good prognostic factor in PUC patients. NT may be repeatable, noninvasive candidate serum biomarker for PUC management.

Keywords

Activity, Antioxidant, Children, Thiol, Ulcerative colitis

Pediatrik Ülseratif Kolit Hastalarında Antioksidan Native Tiyol Düzeyinin İnflmatauvar Markırlar ve Hastalık Aktivite İndeksi ile İlişkisi

Abstract

Amaç: Pediatrik ülseratif kolit (PÜK) inflamatuar bir hastalıktır. PÜK patogenezinde oksidatif stres oluşturan antioksidan aktivite ile reaktif oksijen türleri arasındaki dengesizlik ile ilişkilidir. Native tiyol (NT) seviyesi, iltihaplanma ve antioksidan seviyesinin pratik ve tekrarlanabilir belirteci olan antioksidan kapasitedir. NT düzeyinin inflamatuar belirteçler ve pediatrik ülseratif kolit aktivite indeksi (PÜKAI) ile ilişkisini incelemeyi amaçladık.

Gereç ve Yöntemler: Çalışmaya 38 PÜK hastası (ÇG) ve 33 kontrol grubu (KG) katılımcısı dahil edildi. PÜK hastaları, PUKAI’ye göre hastalık aktivitesi remisyonda, hafif, orta ve şiddetli olarak gruplandı. Tüm katılımcıların NT, hemoglobin (Hb), beyaz kan hücresi (WBC), trombosit (PLT), ortalama trombosit hacmi (MPV), albümin, C-reaktif protein (CRP), eritrosit sedimantasyon hızı (ESH), interlökin 6 (IL-6) seviyeleri ölçüldü ve kaydedildi.

Bulgular: Grupların ortalama yaş ve cinsiyet oranları benzerdi (p>0.050). ÇG’nin NT düzeyi, KG’ye göre istatistiksel olarak yüksek (p=0.001). ÇG’nin Hb, PLT, MPV, CRP, ESR, IL-6 düzeyleri istatistiksel olarak KG’den farklıydı (p=0.045, p=0.026, p=0.001, p=0.001, p=0.001, p=0.001). ÇG’nin NT düzeyi Hb, MPV, albümin ile pozitif korelasyon gösterdi (p=0.001). ÇG’nin NT düzeyi PLT, CRP, ESR, IL-6 ve PUCAI ile negatif korelasyon gösterdi (p=0.001).

Sonuç: PÜK hastalarında NT seviyesi, KG’den anlamlı olarak düşük bulundu. ÇG’nin NT düzeyi PÜK hastalarında iyi bir prognostik faktör olan albümin ile pozitif korelasyon gösterdi. NT ölçümü PÜK yönetimi için tekrarlanabilir, noninvaziv bir serum biyobelirteç olabilir.

Keywords

Aktivite, Antioksidan, Çocuk, Native tiyol, Ülseratif kolit

References

• Rubalcava NS, Gadepalli SK. Inflammatory Bowel Disease in Children and Adolescents. Adv Pediatr 2021; 68:121-42.
• Turner D. Severe acute ulcerative colitis: the pediatric perspective. Dig Dis 2009;27:322-26.
• Karp SM, Koch TR. Oxidative stress and antioxidants in inflammatory bowel disease. Dis Mon 2006; 52: 199– 207.
• Hamouda HE, Zakaria SS, Ismail SA, Khedr MA, Mayah WW. p53 antibodies, metallothioneins, and oxidative stress markers in chronic ulcerative colitis with dysplasia. World J Gastroenterol 2011; 17: 2417–23.
• Pravda J. Radical induction theory of ulcerative colitis. World J Gastroenterol 2005; 11: 2371–284.
• Winther JR, Thorpe C. Quantification of thiols and disulfides. Biochim Biophys Acta 2014;1840: 838-46.
• Rodosskaia NK, Chernousova GM. Immune system and thiols: some peculiarities of thiol exchange. Comp Immunol Microbiol Infect Dis 2010; 33: 65-71.
• Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014; 47: 326-32.
• Patlevič P, Vašková J, Švorc P Jr, Vaško L, Švorc P. Reactive oxygen species and antioxidant defense in human gastrointestinal diseases. Integr Med Res 2016; 5: 250-58.
• Grzybowska-Chlebowczyk U, Wysocka-Wojakiewicz P, Jasielska M, Cukrowska B, Więcek S, Kniażewska M, et al. Oxidative and Antioxidative Stress Status in Children with Inflammatory Bowel Disease as a Result of a Chronic Inflammatory Process. Mediators Inflamm 2018:4120973.
• Birimberg-Schwartz L, Zucker DM, Akriv A, Cucchiara S, Cameron FL, Wilson DC, et al. Development and Validation of Diagnostic Criteria for IBD Subtypes Including IBD-unclassified in Children: a Multicentre Study From the Pediatric IBD Porto Group of ESPGHAN. J Crohns Colitis 2017; 11:1078-84.
• Turner D, Otley AR, Mack D, Hyams J, de Bruijne J, Uusoue K, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology 2007; 133:423-32.
• Holmes EW, Yong SL, Eiznhamer D, Keshavarzian A. Glutathione content of colonic mucosa: evidence for oxidative damage in active ulcerative colitis. Dig Dis Sci 1998; 43:1088-95.
• Tsunada S, Iwakiri R, Ootani H, Aw TY, Fujimoto K. Redox imbalance in the colonic mucosa of ulcerative colitis. Scand J Gastroenterol 2003; 38:1002-3.
• Neselioglu S, Keske PB, Senat AA, Yurekli OT, Erdogan S, Alisik M,  et al. The relationship between severity of ulcerative colitis and thiol-disulphide homeostasis. Bratisl Lek Listy 2018;119: 498-502.
• Mahadea D, Adamczewska E, Ratajczak AE, Rychter AM, Awada A, Eder P, et al. Iron Deficiency Anemia in Inflammatory Bowel Diseases-A Narrative Review. Nutrients 2021;13:4008.
• Holtman GA, Lisman-van Leeuwen Y, Day AS, Fagerberg UL, Henderson P, Leach ST, et al. Use of Laboratory Markers in Addition to Symptoms for Diagnosis of Inflammatory Bowel Disease in Children: A Meta-analysis of Individual Patient Data. JAMA Pediatr 2017;171:984-91.
• Kapsoritakis AN, Koukourakis MI, Sfiridaki A,Potamianos SP, Kosmadaki MG, Koutroubakis IE, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001; 96: 776-81.
• Chen Z, Lu Y, Wu J, Zhang H. Clinical significance of blood platelets and mean platelet volume in patients with ulcerative colitis. J Int Med Res 2021; 49: 3000605211009715.
• Voudoukis E, Karmiris K, Koutroubakis IE. Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. World J Gastroenterol 2014; 20:3180-90.
• Cifci S, Ekmen N. Prediction of Mucosal Health by NLR, CRP x NLR and MPV in Ulcerative Colitis: Can Their Availability Change According to Treatment Options? Cureus 2021; 13:e19942.
• Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut 2006; 55: 426-31.
• Croft A, Lord A, Radford-Smith G. Markers of systemic inflammation in acute attacks of ulcerative colitis: What level of C-reactive protein constitutes severe colitis? J Crohns Colitis 2022;11:jjac014.
• Feng JS, Yang Z, Zhu YZ, Liu Z, Guo CC, Zheng XB. Serum IL-17 and IL-6 increased accompany with TGF-β and IL-13 respectively in ulcerative colitis patients. Int J Clin Exp Med 2014; 7:5498-04.
• Karaskova E, Volejnikova J, Holub D, Velganova-Veghova M, Spenerova M, Mihal V, et al. Changes in serum hepcidin levels in children with inflammatory bowel disease during anti-inflammatory treatment. J Paediatr Child Health 2020; 56: 276-82.