Assessment of nitric oxide and uric acid in patients of leprosy

Background: Leprosy is an old, dreaded infectious disease caused by the obligate intracellular bacterium mycobacterium leprae. Leprosy still continues to be a significant public health problem in few countries including India. Oxidative stress caused by derangement in the balance between ROS and natural antioxidants plays a crucial role in the pathogenesis of leprosy. Hence this study attempts to assess the oxidative stress and antioxidant status in terms of Nitric oxide and uric acid.Methods: A case control observational study was carried out in100 untreated leprosy patients and compared with 50 healthy controls.  Leprosy patients were divided as paucibacillary and multibacillary. Serum Nitric oxide and uric acid levels were estimated in both groups to find out correlation of Nitric Oxide with uric acid.Results: There was a significant rise in serum NO in both PB and MB leprosy as compared to controls. The uric acid level was significantly decreased in both PB and MB leprosy patients as compared to controls.Conclusions: Elevated NO levels indicate oxidative stress in leprosy patients, denoting its crucial involvement in the pathogenesis and nerve damage in leprosy. Low uric acid indicates decrease defence of antioxidants in leprosy.

Association between various antioxidants in normals and chronic obstructive pulmonary disease, their alteration and impact of smoking and disease on levels of antioxidants

Background: There is total alteration of various antioxidants in response to the oxidative stress, which is one of the major patho-physiologic hallmarks in chronic obstructive pulmonary disease (COPD) development. This study aims to establish the correlation between different antioxidants in normals and COPD, study the alteration in the correlation due to COPD and smoking as well as the impact of COPD and smoking on antioxidants levels.Methods: Study comprises of 96 normals as group I and 96 COPD patients as group II. The antioxidants albumin (Alb), bilirubin (Bil), uric acid (UA) ceruloplasmin (Cp), glutathione peroxidase (GSHPx), catalase (CAT) and superoxide dismutase 3 (SOD3) were estimated.Results: Significant lower serum Alb, UA, SOD3 and increased serum Cp and GSHPx were found in Group II. Significant correlation was found between Alb and UA (r=0.24); Bil and UA (r=0.26); Alb and CAT (r=0.211) and SOD3 and CAT (r=0.318) in normals. However, these correlations were altered in COPD where Alb correlates with Bil (r=0.235); UA with CAT (r=0.203) and SOD3 with GSHPx (r=-0.27). The correlation between SOD3 and CAT remained unaltered. Similar correlation of UA with Alb and Bil was observed in nonsmoker normals and between SOD3 and CAT in smoker normals. In COPD, no correlation was seen in nonsmokers, while in smokers Alb correlates with Bil (r=0.316) and SOD3 with CAT (r=0.317).Conclusions: These alterations may have clinical ramifications in further understanding the pathogenesis of COPD and developing therapeutic approaches.

Total Antioxidant Capacity: Correlation with Other Antioxidants and Clinical Utility of Their Levels in Chronic Obstructive Pulmonary Disease.

Oxidative stress is one of the major pathophysiologic hallmarks in the development of COPD and lung is protected against this by enzymatic and non-enzymatic antioxidants. Total antioxidant activity (TAC), may give more relevant biological information about the individual's overall antioxidant status compared to individual components. This study aims to evaluate correlation between TAC and other antioxidants bilirubin, albumin, urate and ceruloplasmin (CP) and explore the clinical utility of their levels in diagnosis of COPD. Study Design: Comparison study. Place and Duration of Study: Cardio Thoracic Centre, Pune and Department of Biochemistry, AFMC, Pune during Dec 2010 to Aug 2012. Methodology: Study comprised of 86 normals as controls group and 86 confirmed COPD patients as COPD group. CP was estimated by patented kinetic method of Somani and Ambade, while all other analytes were estimated by using commercially available kits. Results: CP was significantly higher in COPD patients (1392.8±281.6 IU/L) as compared to controls (1006.2±236.1 IU/L) while levels of albumin, urate and TAC were significantly lower in COPD patients. The levels in COPD and controls are albumin: 3.8±0.5 and 4.3± 0.4g/dL; urate: 4.4±1.3 and 5±1.3 mg/dL; TAC: 27.7±6.9 and 36±8.2 mmolTE/L respectively. No appreciable correlation was noticed between any individual antioxidant and TAC. Conclusion: CP and TAC showed statistically significant differences between controls and COPD patients and may have clinical utility in the management of COPD. However, the estimation of TAC is to be done with extreme care.

Oxidative Stress in Chronic Obstructive Pulmonary Disease Alters Ferroxidase Activity of Ceruloplasmin.

Aims: Oxidative stress is one of the major patho-physiologic hallmarks in the development of COPD. Ceruloplasmin, the major serum inhibitor of lipid peroxidation has been documented as a main extracellular antioxidant in serum and plays a role in preventing lung injury, and an abnormality in its oxidative inhibition could be involved in pathogenesis of COPD. This study aims to estimate levels of ceruloplasmin and its ferroxidase activity in COPD and compare with that in controls to explore their utility in COPD. Study Design: Comparison study. Place and Duration of Study: Department of Biochemistry, AFMC, Pune. Subjects for COPD were selected from the patients reporting with symptoms of COPD to respiratory OPD of Cardio Thoracic Centre, Pune, during Dec 2010 to Aug 2012. Methodology: Study comprised of two groups: Group I of 77 normal as controls (61 men, 16 women; age range 27-90 years) and Group II of 92 COPD patients (70 men, 22 women; age range 45 - 97 years). Both the groups were further divided into smoker and nonsmoker groups. Ferroxidase activity of ceruloplasmin was estimated by indigenous patented kinetic method of Somani and Ambade while ceruloplasmin was estimated by immunotubidimetric method using commercially available kit. Results: Serum ceruloplasmin and ferroxidase activity were significantly higher in COPD patients as compared to normal controls. Mean ± SD in COPD versus controls respectively are ceruloplasmin: 45.84 ± 12.7 mg/dL versus 37 ± 9.7 mg/dL; ferroxidase: 1324.9 ± 278.53 IU/L versus 980.5 ± 202.3 IU/L, P< .001. Statistically significant & good correlation (r > 0.7) was found between ceruloplasmin and ferroxidase in controls, nonsmoker controls and smoker controls (r = 0.76, 0.71 and 0.79 respectively) while in COPD, COPD nonsmokers and COPD smokers, no correlation was found (r = 0.00, 0.29 and 0.09 respectively). Conclusion: There is alteration in the ferroxidase activity of ceruloplasmin in COPD. Future studies with quantification of carbonyl residues or other groups in ceruloplasmin molecule leading to altered oxidative or ferroxidase activity of ceruloplasmin may provide further evidence to support a role of oxidative stress in COPD.

Serum magnesium in pregnancy induced hypertension.

Background: PIH is a major cause of maternal & perinatal morbidity & mortality worldwide because of its complications. The etiology of PIH is uncertain but appears to be related to uteroplacental ischaemia. Magnesium is one of the principle macronutrients, regulates vascular tone, causes relaxation of muscles of uterus and decreases excitability of nerves & muscles. Hence the study was planned to estimate and compare the levels of magnesium between women with PIH and normal pregnant women. Methods: The study comprised of thirty clinically diagnosed PIH patients and thirty gestational age-matched controls. Serum magnesium was estimated spectrophotometrically. Results: Significant decrease was observed in magnesium levels in women with PIH as compared to normal pregnant women. Conclusion: The decreased serum magnesium levels may indicate its possible role as one of the risk factors in the development of PIH in pregnant women. Hence the screening of clinically diagnosed cases of PIH for hypomagnesemia may help in minimizing the complications of PIH. Hypomagnesemia could be treated with magnesium supplementation and follow up of the patients for complications would be necessary to comment further.

Oxidative stress and antioxidant vitamins in leprosy.

Background: Leprosy is a disease of great antiquity and it still continues to be a significant public health problem in few countries including India .Of the various mechanisms that influence the pathogenesis of leprosy, oxidative stress is important which occurs due to derangement in the balance between ROS and natural antioxidants. Hence this study attempted to assess the oxidative stress and antioxidant status in terms of MDA and vitamin E, vitamin C respectively in leprosy. Methods: Hundred untreated leprosy patients (50 PB and 50 MB) were studied and compared with 50 healthy controls. Serum Malondialdehyde (MDA) and vitamin E, vitamin C was measured by spectrophotometric method. Serum malondialdehyde (MDA) was measured as an indicator of lipid peroxidation and antioxidant status was assessed by estimating serum vitamin E and vitamin C levels. Results: Significant rise in serum MDA (P <0.001) in both PB and MB leprosy was seen when compared with controls. The vitamin E level was significantly decreased in both PB and MB leprosy patients as compared to controls. The vitamin C level was significantly decrease (P<0.001) in MB leprosy patients as compared to controls. Conclusions: Elevated MDA levels indicate oxidative stress in leprosy patients, denoting its crucial involvement in the pathogenesis and tissue damage in leprosy. Hence MDA levels can be used to monitor prognosis, treatment and control of leprosy. Decreased vitamin E, C levels in leprosy can be improved by oral vitamin E, C supplementation.