I型高须动脉炎的氧化应激和抗氧化系统

A. Gaibov, O. Nematzoda, B. I. Kobilbekov, Yu. M. Kosimov, S. Ali-Zade
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The study of the above markers was carried out in two stages: upon admission of patients in the stage of exacerbation of inflammation and after targeted anti-inflammatory, immunomodulatory and antioxidant therapy – in the stage of remission of the inflammatory process. Results: The study of LPO and AOS showed that in all patients, upon admission, there was a considerable oxidant-antioxidant imbalance due to an acute inflammatory process. MDA was increased by 2.6 times constituting 3.9±0.1 μmol/l. After pathogenetically targeted therapy, its significant decrease to 2.9±0.1 μmol/l (р˂0.001) was achieved. Activation of LPO was paralleled with a significant decrease of the body's AOS markers. The activity of SOD and concentration of AA during acute inflammatory process was reduced by 1.4 and 1.3 times, and amounted to 13.3±0.1 c.u./l and 57.8±0.3 μmol/l, respectively. After pulse therapy these indicators showed a significant increase compared with the initial data: up to 15.9±0.2 c.u./l and 63.9±0.4 μmol/l, respectively. The content of SA, which is one of the important components of cell membrane glycoproteins and glycolipids, was increased by 2.3 times (6.1±0.1 mmol/l), while after treatment it significantly decreased to 3.4±0.1 mmol/l (p˂0.001). Gender and age did not affect the dynamics of the specified markers, except for SA, which showed higher values in women (p<0.05). Conclusion: With TA in the stage of acute inflammation, increased content of MDA was found, indicating development of the oxidative stress. On this background the AOS indicators were decreased, which should be taken into account during preoperative preparation of patients for upcoming revascularization. The inclusion antioxidants in the protocol of standard TA therapy may improve the patients’ outcomes. 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引用次数: 0

摘要

目的:探讨以头臂血管病变为主的高须动脉炎(NF)患者血液脂质过氧化(LPO)及抗氧化系统(AOS)的特点。方法:对16例炎症过程主要局限于主动脉弓及其分支的I型TA患者进行LPO(丙二醛- MDA)、AOS(超氧化物歧化酶- SOD、抗坏血酸- AA)和炎症(唾液酸- SA)标志物的研究。TA最常见于女性(n=14;87.5%),患者平均年龄20.8±0.8岁。上述标志物的研究分两个阶段进行:患者入院时炎症加重阶段和靶向抗炎、免疫调节和抗氧化治疗后炎症过程缓解阶段。结果:LPO和AOS的研究表明,在所有患者入院时,由于急性炎症过程,存在相当大的氧化-抗氧化失衡。MDA增加2.6倍,达到3.9±0.1 μmol/l。经病理靶向治疗后,其浓度显著降低至2.9±0.1 μmol/l(±0.001)。LPO的激活与机体AOS标志物的显著降低是平行的。急性炎症过程中SOD活性降低1.4倍,AA浓度降低1.3倍,分别为13.3±0.1 μmol/l和57.8±0.3 μmol/l。经脉冲治疗后,这些指标与初始数据相比显着增加:分别高达15.9±0.2 μmol/l和63.9±0.4 μmol/l。SA是细胞膜糖蛋白和糖脂的重要成分之一,其含量增加了2.3倍(6.1±0.1 mmol/l),而处理后显著降低到3.4±0.1 mmol/l (p小于0.001)。性别和年龄对特定标记物的动态没有影响,但SA在女性中表现出更高的值(p<0.05)。结论:TA在急性炎症阶段,MDA含量升高,提示氧化应激的发生。在此背景下,AOS指标下降,这应该在患者术前准备即将到来的血运重建术时考虑到。在标准TA治疗方案中加入抗氧化剂可以改善患者的预后。关键词:高松动脉炎,脂质过氧化,抗氧化系统,丙二醛,超氧化物歧化酶,抗坏血酸,唾液酸
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OXIDATIVE STRESS AND ANTIOXIDANT SYSTEM IN TYPE I TAKAYASU ARTERITIS
Objective: To study the features of lipid peroxidation (LPO) and the antioxidant system (AOS) in blood in Takayasu arteritis (NF) with a predominant lesion of brachiocephalic vessels. Methods: Several markers of LPO (malondialdehyde – MDA), AOS (superoxide dismutase – SOD, ascorbic acid – AA) and inflammation (sialic acid – SA) were studied in 16 patients with type I TA, where the inflammatory process was localized mainly in the aortic arch and its branches. Most commonly TA was observed among females (n=14; 87.5%), the average age of patients was 20.8±0.8 years. The study of the above markers was carried out in two stages: upon admission of patients in the stage of exacerbation of inflammation and after targeted anti-inflammatory, immunomodulatory and antioxidant therapy – in the stage of remission of the inflammatory process. Results: The study of LPO and AOS showed that in all patients, upon admission, there was a considerable oxidant-antioxidant imbalance due to an acute inflammatory process. MDA was increased by 2.6 times constituting 3.9±0.1 μmol/l. After pathogenetically targeted therapy, its significant decrease to 2.9±0.1 μmol/l (р˂0.001) was achieved. Activation of LPO was paralleled with a significant decrease of the body's AOS markers. The activity of SOD and concentration of AA during acute inflammatory process was reduced by 1.4 and 1.3 times, and amounted to 13.3±0.1 c.u./l and 57.8±0.3 μmol/l, respectively. After pulse therapy these indicators showed a significant increase compared with the initial data: up to 15.9±0.2 c.u./l and 63.9±0.4 μmol/l, respectively. The content of SA, which is one of the important components of cell membrane glycoproteins and glycolipids, was increased by 2.3 times (6.1±0.1 mmol/l), while after treatment it significantly decreased to 3.4±0.1 mmol/l (p˂0.001). Gender and age did not affect the dynamics of the specified markers, except for SA, which showed higher values in women (p<0.05). Conclusion: With TA in the stage of acute inflammation, increased content of MDA was found, indicating development of the oxidative stress. On this background the AOS indicators were decreased, which should be taken into account during preoperative preparation of patients for upcoming revascularization. The inclusion antioxidants in the protocol of standard TA therapy may improve the patients’ outcomes. Keywords: Takayasu arteritis, lipid peroxidation , antioxidant system, malondialdehyde, superoxide dismutase, ascorbic acid, sialic acid.
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