Purpose: The aim of this study was to investigate the relationship between serum dynamic thiol-disulfide homeostasis (TDH) and sepsis, in adult patients. Materials and Methods: In this observational, prospective, case-control study patients (n=44) diagnosed with sepsis compared with ages and gender-matched healthy controls (n=44). Patients were divided into two subgroups (survivors and non-survivors) dependent variable being remaining alive on the 28th day after ICU admission at the follow-up period. TDH parameters measured using a novel automatic and spectrophotometric method and compared statistically. Results: In patients with sepsis, native thiol, total thiol, and disulfide levels were lower than the control group, and this difference was statistically significant. TDH parameters between surviving and non-surviving patients were similar at the sepsis diagnosis. However, significant differences found in native and total thiol levels at follow-up via repeated measurement analyses on days 3 and 7 in surviving and non-surviving sub-groups. Conclusion: This study showed that impairment in dynamic TDH in adults with sepsis may be related to negative outcomes.
1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801-10.
2. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014; 311(13):1308-16.
3. Baykara N, Akalın H, Arslantaş MK, Hancı V, Çağlayan Ç, Kahveci F, et al. Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study. Critical Care. 2018;22:93.
4. Hall MJ, Williams SN, DeFrances CJ, Golosinskiy A. Inpatient care for septicemia or sepsis: a challenge for patients and hospitals. NCHS Data Brief. 2011;62:1-8.
5. Kaymak C, Basar H, Sardas S. Reactive oxygen species (Ros) generation in sepsis. FABAD J Pharm Sci. 2011;36:41-7.
6. Bickers DR, Athar M. Oxidative stress in the pathogenesis of skin diseases. J Invest Dermatol. 2006;126:2565-75.
7. Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochemic Cell Biol. 2007;39:44-84.
8. Prakash M, Shetty MS, Tilak P, Anwar N. Total thiols: biomedical importance and their alteration in various disorders. Online J Health Allied Scs. 2009;8:2.
9. Jones DP, Liang Y. Measuring the poise of thiol/disulfide couples in vivo. Free Radic Biol Med. 2009;47:1329-38.
10. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47:326-32.
11. Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818-29.
12. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The Sepsis-related Organ Failure Assessment (SOFA) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22:707-10.
13. Kolgelier S, Ergin M, Demir LS, Inkaya AC, Demir NA, Alisik M, et al. Impaired thiol-disulphide balance in acute brucellosis. Jpn J Infect Dis. 2016;JJID-2016.
14. Tufan ZK, Hasanoglu I, Kolgelier S, Alisik M, Ergin M, Yilmaz GR, et al. A retrospective controlled study of thiol disulfide homeostasis as a novel marker in Crimean Congo hemorrhagic fever. Redox Report. 2017;22:241-45.
15. Kara SS, Erel O, Demirdag TB, Cura Yayla BC, Gulhan B, Neselioglu S, et al. Alteration of thiol-disulphide homeostasis in acute tonsillopharyngitis. Redox Report. 2017;22:205-09.
16. Ayar G, Sanliay S, Men Atmaca Y, Yazici, Mutlu Uysal U, Neselioglu S, Erel O. Thiol-disulphide homeostasis is an oxidative stress indicator in critically ill children with sepsis. Arch Argent Pediatr. 2019;117:143-48.
17. Haddad JJ. Oxygen sensing and oxidant/redox-related pathways. Biochem Biophys Res Commun. 2004;316:969-77.
18. Kumar S, Gupta E, Kaushik S, Kumar Srivastava V, Mehta SK, Jyoti A. Evaluation of oxidative stress and antioxidant status: Correlation with the severity of sepsis. Scand J Immunol. 2018;87:e12653.
19. Karapetsa M, Pitsika M, Goutzourelas N, Stagos D, Becker AT, Zakynthinos E. Oxidative status in ICU patients with septic shock. Food Chem. Toxicol. 2013;61:106-111.
20. Cowley HC, Bacon PJ, Goode HF, Webster NR, Jones JG, Menon DK. Plasma antioxidant potential in severe sepsis: a comparison of survivors and nonsurvivors. Crit. Care Med. 1996;24:1179-83.
21. Turell L, Radi R, Alvarez B. The thiol pool in human plasma: the central contribution of albumin to redox processes. Free Radic Biol Med. 2013;65:244-53.
22. Schieber M, Chandel NS. ROS function in redox signaling and oxidative stress. Curr Biol. 2014;24:R453-R462.
23. Topuz M, Kaplan M, Akkus O, Sen O, Yunsel HD, Allahverdiyev S, et al. The prognostic importance of thiol/disulfide homeostasis in patients with acute pulmonary thromboembolism. Am J Emerg Med. 2016;34:2315-19.
24. Bektas H, Vural G, Gumusyayla S, Deniz O, Alisik M, Erel O. Dynamic thiol–disulfide homeostasis in acute ischemic stroke patients. Acta Neurol Belg. 2016;116:489-94.
25. Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med. 2003;348:138-50.
26. Khwannimit B. A comparison of three organ dysfunction scores: MODS, SOFA and LOD for predicting ICU mortality in critically ill patients. J Med Assoc Thai. 2007;90:1074-81.
27. Charan B, Arjun LK, Varsha SD, Zubin DS. Sequential organ failure assessment score as prognostic marker in critically ill patients in a tertiary care intensive care unit. Int. J. Public Health. 2013;3:155-8.
Sepsis için yeni bir oksidatif stres biyobelirteci: dinamik tiyol-disülfür homeostazisi
Year 2020,
Volume: 45 Issue: 1, 63 - 70, 31.03.2020
Amaç: Bu gözlemsel, prospektif, vaka kontrol çalışmasında erişkin hastalarda serum dinamik Tiyol-Disülfir Homeostazisi (TDH) ile sepsis arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Sepsis tanısı ile alan 44 hasta, yaş ve cinsiyet uyumlu 44 sağlıklı kontrol ile karşılaştırıldı. Hastalar yoğun bakım ünitesi yatışından sonraki 28. günde sağ-kalan ve hayatını kaybedenler olarak 2 gruba ayrıldı. TDH parametreleri yeni, otomatik ve spektrofotometrik bir yöntem kullanılarak ölçüldü ve sonuçlar istatistiksel olarak karşılaştırıldı. Bulgular: Sepsisli hastalarda, nativ tiyol, total tiyol ve disülfit seviyeleri kontrol grubuna göre daha düşük olarak bulundu ve bu fark istatistiksel olarak anlamlı idi. Başlangıç TDH parametreleri sağ-kalan ve hayatını kaybeden hastalar arasındaki benzer bulundu. Ancak sağ kalan ve ex olan hastaların 3 ve 7. günde tekrarlanan TDH ölçümleri (nativ ve toplam tiyol seviyeleri) arasında anlamlı farklar bulundu. Sonuç: Bu çalışma, erişkin sepsis hastalarında dinamik TDH'deki bozulmanın negatif sonuçlara ilişkili olabileceğini göstermiştir.
1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801-10.
2. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014; 311(13):1308-16.
3. Baykara N, Akalın H, Arslantaş MK, Hancı V, Çağlayan Ç, Kahveci F, et al. Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study. Critical Care. 2018;22:93.
4. Hall MJ, Williams SN, DeFrances CJ, Golosinskiy A. Inpatient care for septicemia or sepsis: a challenge for patients and hospitals. NCHS Data Brief. 2011;62:1-8.
5. Kaymak C, Basar H, Sardas S. Reactive oxygen species (Ros) generation in sepsis. FABAD J Pharm Sci. 2011;36:41-7.
6. Bickers DR, Athar M. Oxidative stress in the pathogenesis of skin diseases. J Invest Dermatol. 2006;126:2565-75.
7. Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochemic Cell Biol. 2007;39:44-84.
8. Prakash M, Shetty MS, Tilak P, Anwar N. Total thiols: biomedical importance and their alteration in various disorders. Online J Health Allied Scs. 2009;8:2.
9. Jones DP, Liang Y. Measuring the poise of thiol/disulfide couples in vivo. Free Radic Biol Med. 2009;47:1329-38.
10. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47:326-32.
11. Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818-29.
12. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The Sepsis-related Organ Failure Assessment (SOFA) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22:707-10.
13. Kolgelier S, Ergin M, Demir LS, Inkaya AC, Demir NA, Alisik M, et al. Impaired thiol-disulphide balance in acute brucellosis. Jpn J Infect Dis. 2016;JJID-2016.
14. Tufan ZK, Hasanoglu I, Kolgelier S, Alisik M, Ergin M, Yilmaz GR, et al. A retrospective controlled study of thiol disulfide homeostasis as a novel marker in Crimean Congo hemorrhagic fever. Redox Report. 2017;22:241-45.
15. Kara SS, Erel O, Demirdag TB, Cura Yayla BC, Gulhan B, Neselioglu S, et al. Alteration of thiol-disulphide homeostasis in acute tonsillopharyngitis. Redox Report. 2017;22:205-09.
16. Ayar G, Sanliay S, Men Atmaca Y, Yazici, Mutlu Uysal U, Neselioglu S, Erel O. Thiol-disulphide homeostasis is an oxidative stress indicator in critically ill children with sepsis. Arch Argent Pediatr. 2019;117:143-48.
17. Haddad JJ. Oxygen sensing and oxidant/redox-related pathways. Biochem Biophys Res Commun. 2004;316:969-77.
18. Kumar S, Gupta E, Kaushik S, Kumar Srivastava V, Mehta SK, Jyoti A. Evaluation of oxidative stress and antioxidant status: Correlation with the severity of sepsis. Scand J Immunol. 2018;87:e12653.
19. Karapetsa M, Pitsika M, Goutzourelas N, Stagos D, Becker AT, Zakynthinos E. Oxidative status in ICU patients with septic shock. Food Chem. Toxicol. 2013;61:106-111.
20. Cowley HC, Bacon PJ, Goode HF, Webster NR, Jones JG, Menon DK. Plasma antioxidant potential in severe sepsis: a comparison of survivors and nonsurvivors. Crit. Care Med. 1996;24:1179-83.
21. Turell L, Radi R, Alvarez B. The thiol pool in human plasma: the central contribution of albumin to redox processes. Free Radic Biol Med. 2013;65:244-53.
22. Schieber M, Chandel NS. ROS function in redox signaling and oxidative stress. Curr Biol. 2014;24:R453-R462.
23. Topuz M, Kaplan M, Akkus O, Sen O, Yunsel HD, Allahverdiyev S, et al. The prognostic importance of thiol/disulfide homeostasis in patients with acute pulmonary thromboembolism. Am J Emerg Med. 2016;34:2315-19.
24. Bektas H, Vural G, Gumusyayla S, Deniz O, Alisik M, Erel O. Dynamic thiol–disulfide homeostasis in acute ischemic stroke patients. Acta Neurol Belg. 2016;116:489-94.
25. Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med. 2003;348:138-50.
26. Khwannimit B. A comparison of three organ dysfunction scores: MODS, SOFA and LOD for predicting ICU mortality in critically ill patients. J Med Assoc Thai. 2007;90:1074-81.
27. Charan B, Arjun LK, Varsha SD, Zubin DS. Sequential organ failure assessment score as prognostic marker in critically ill patients in a tertiary care intensive care unit. Int. J. Public Health. 2013;3:155-8.