接受噻马唑保守治疗的巴塞杜氏病患者血液中的中性粒细胞原发性活性氧生成水平。

M. Dudina, S. Dogadin, A. A. Savchenko, I. Gvozdev
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引用次数: 0

摘要

背景。使用噻马唑对巴塞杜氏病进行保守治疗有助于通过恢复甲状腺功能和血浆总活性抗氧化潜能来降低氧化应激水平。然而,迄今为止,在巴塞杜氏病患者中,中性粒细胞在药物诱导甲状腺功能亢进不同持续时间的自由基转化初期产生自由基的能力仍未得到研究,而这对于揭示疾病复发的机制似乎意义重大。本文旨在研究巴塞杜氏病患者外周血中性粒细胞中初级活性氧的生成水平取决于药物诱导甲状腺功能亢进的持续时间。材料与方法在实验室确诊的巴塞杜氏病患者中开展了一项单中心、前瞻性、对照研究。根据持续使用噻马唑保守治疗后药物诱导甲状腺功能亢进的持续时间,对巴塞杜氏病患者进行分组。通过化学发光法测定外周血中性粒细胞产生的 ROS 水平。在 36 通道化学发光分析仪 BLM-3607 (Medbiotech LLC,克拉斯诺亚尔斯克)上对自发化学发光和紫霉素诱导化学发光进行了 90 分钟的评估。研究结果研究对象包括 102 名患巴塞杜氏病的女性,平均年龄(47.54 ± 15.47)岁。其中,75人(73.5%)病情复发,27人(26.47%)新近确诊。在甲状腺状态持续时间为 5-8 个月和 9-12 个月的受检患者中,(S) 原发性 ROS 的总合成量与对照值相比有显著的统计学增长。研究发现,在药物诱导甲状腺功能稳定达5-8个月和9-12个月的巴塞杜氏病患者中,紫杉醇诱导的中性粒细胞荧光素依赖性化学发光的S指数在统计学上比对照值分别显著增加了10.7倍和7.4倍。结论在保守治疗噻马唑的背景下,巴塞杜氏病患者恢复并维持药物诱导的甲状腺功能亢进超过12个月,可减少全身氧化应激对免疫系统造成的负荷。然而,巴塞杜氏病患者的中性粒细胞在噻马唑保守疗法的药物诱导甲状腺功能亢进状态下产生的原发性ROS总量较高,这可能会对NADPH氧化酶复合物的功能发挥重要作用,并在疾病复发时决定中性粒细胞的功能能力。
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The level of blood neutrophils primary reactive oxygen species production in Graves’ disease patients undergoing conservative therapy with thiamazole.
Background. Conservative therapy with thiamazole in Graves’ disease helps to reduce the level of oxidative stress by restoring euthyroidism and the total reactive antioxidant potential of plasma. However, until now, in patients with Graves’ disease, the radical-producing ability of neutrophils remains unexplored at the initial stage of free radical conversion at different durations of drug-induced euthyroidism, which seems significant in revealing the mechanisms of disease recurrence. The aim is to study the level of production of primary reactive oxygen species in peripheral blood neutrophils depending on the duration of drug — induced euthyroidism in patients with Graves’ disease. Materials and methods. A single-center, prospective, controlled study was conducted with the participation of patients with laboratory-confirmed Graves’ disease. Subgroups of patients with Graves’ disease were formed depending on the duration of achieved drug-induced euthyroidism with continuous conservative therapy with thiamazole. The level of ROS production in peripheral blood neutrophils was determined by chemiluminescence. The assessment of spontaneous and zymosan-induced chemiluminescence was carried out for 90 minutes on a 36-channel chemiluminescence analyzer BLM-3607 (Medbiotech LLC, Krasnoyarsk). Results. The study included 102 Graves’ disease women with an average age of 47.54 ± 15.47 years. Of these, 75 (73.5 %) with relapse and 27 (26.47 %) with newly diagnosed disease. The total synthesis of (S) primary ROS increased statistically significantly relative to the control values in the examined patients with a duration of the euthyroid state of 5–8 and 9–12 months. It was found that in patients with Graves’ disease with stable drug-induced euthyroidism for 5–8 and 9–12 months, the S index of zymosan-induced lucigenin-dependent chemiluminescence of neutrophils increased statistically significantly, respectively, by 10.7 and 7.4 times relative to the control values. Conclusion. The restoration and maintenance of drug-induced euthyroidism for more than 12 months against the background of conservative thiamazole therapy in patients with Graves’ disease reduces the load of systemic oxidative stress on the immune system. However, the high total production of primary ROS in neutrophils of patients with Graves’ disease in a state of drug-induced euthyroidism with conservative thiamazole therapy may play a significant role in disconnecting the functioning of the NADPH oxidase complex and determine the functional capabilities of neutrophils in case of disease recurrence.
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