Does thiol-disulphide balance in tissue and serum play a role in disease management in ureteropelvic junction stenosis?

Background: The study aimed at evaluating the role of thiol-disulphide balance parameters [native thiol (SH), total thiol (SH + SS), disulphide (SS), disulphide/native thiol ratio (% SS/SH), disulphide/total thiol ratio (% SS/Total Thiol) and native thiol/total thiol ratio (%SH/Total Thiol)], which are important oxidative stress markers in the congenital ureteropelvic junction (UPJ) stenosis, in the diagnosis of the disease, and its role in determining the need for surgery and follow-up.

Materials and methods: This prospective study included 30 children diagnosed with congenital intrinsic ureteropelvic junction obstruction (UPJO) and a control group of 30 healthy children admitted to the pediatric clinic between January 2016 and February 2017. The children with UPJO underwent laparoscopic dismembered pyeloplasty. Thiol-disulphide balance parameters were assessed in both the peripheral blood and the excised tissue from the narrowed segment of the UPJ during surgery, as well as in the peripheral blood of the control group. Serum levels of native thiol (SH), total thiol (SH + SS), disulphide (SS), the disulphide/native thiol ratio (% SS/SH), the disulphide/total thiol ratio (% SS/Total Thiol), and the native thiol/total thiol ratio (% SH/Total Thiol) were subsequently compared between the two groups. In the UPJO cohort, correlation analyses were conducted to examine relationships between serum and tissue results for native thiol, total thiol, disulphide, % SS/SH, % SS/Total Thiol, and % SH/Total Thiol, alongside Tc(Technetium)-99m MAG-3 (mercaptoacetyltriglycine) differential renal function (DRF) (%), renal pelvic anterior-posterior (AP) diameter, renal parenchymal thickness, and plasma creatinine levels.

Results: The findings of this study indicated statistically significant differences in serum levels of native thiol, total thiol, disulphide, % SS/SH, % SS/Total Thiol, and % SH/Total Thiol between the UPJO and control groups. Specifically, the UPJO group exhibited higher values of serum disulphide, % SS/SH, and % SS/Total Thiol, while serum levels of native thiol, total thiol, and % SH/Total Thiol were significantly lower (p < 0.05). Furthermore, no statistically significant correlations were observed in the UPJO group between tissue and serum results for native thiol, total thiol, disulphide, % SS/SH, % SS/Total Thiol, % SH/Total Thiol, and clinical parameters including MAG-3 differential renal function (DRF) (%), pelvic anterior-posterior (AP) diameter, renal parenchymal thickness, and plasma creatinine levels.

Conclusions: The UPJO group displayed significantly elevated levels of serum disulphide, % SS/SH, and % SS/Total Thiol compared to the control group, while serum native thiol, total thiol, and % SH/Total Thiol were notably lower. Additionally, no correlations were found between serum and tissue thiol-disulphide balance parameters and clinical measures such as MAG-3 DRF (%), pelvic AP diameter, parenchymal thickness, and plasma creatinine levels. Further comprehensive studies are warranted to identify new biomarkers for monitoring UPJ stenosis.