A study of oxidative stress biomarkers and effect of oral antioxidant supplementation in severe acute malnutrition.

BACKGROUND: Malnutrition represents one of the most severe health problems in India. Free radicals play an important role in immunological response, which induces the oxidative surplus in severe acute malnutrition. Severe dietary deficiency of nutrients leads to increased oxidative stress in cellular compartments. AIM: The goal of this study was to inspect impact of oxidative stress in the form of serum malondialdehyde as product of lipid peroxidation, vitamin E, zinc and erythrocyte superoxide dismutase in patients with severe acute malnutrition. MATERIAL AND METHODS: Sixty severe acute malnutrition patients were studied before and after supplementation of antioxidants for one month, and their status were compared with those of 60 age and sex matched healthy controls. The level of serum MDA was analyzed by the Kei Satoh method, serum vitamin E concentration was measured by Baker and Frank Method, serum zinc was measured by using Atomic Absorption Spectrophotometer (AAS) and erythrocyte superoxide dismutase was measured by Kajari Das Method. RESULTS: Significantly increased levels of serum malondialdehyde (p<0.001) were found in the patients as compared to those in controls, and significant depletions were found in the levels of serum vitamin E, zinc and erythrocyte superoxide dismutase in patients with severe acute malnutrition as compared to those in controls. After supplementation of antioxidants for one month, the levels of malondialdehyde were found to be decreased significantly (p<0.001) and zinc and erythrocyte superoxide dismutase capacity levels were increased significantly (p<0.05). Also, there was a non-significant (p>0.05) increase in vitamin E levels as compared to those before supplementation results. CONCLUSION: Harsh deficiency of various nutrients in severe acute malnutrition leads to generation of heavy oxidative stress. These effects may be minimized with supplementation of antioxidants.

Biochemical effects of lead exposure on battery manufacture workers with reference to blood pressure, calcium metabolism and bone mineral density.

Lead is one of the most widely scattered toxic metals in the environment and used by mankind for over 9,000 years. Lead in the environment may be derived from natural or anthropogenic sources. In humans, lead can cause a wide range of biological effects depending upon the level and duration of exposure. The purpose of this study was to find out the effect of lead exposure on systolic and diastolic blood pressure, serum calcium, ionized calcium, phosphorus, parathyroid hormone and vitamin D and examine the overall effect of all these parameters on the bone mineral density of battery manufacture workers. For this study ninety battery manufacture workers were selected and divided in three groups depending upon duration of lead exposure. Group I-workers with duration of lead exposure 1-5 years, Group II-workers with duration of lead exposure 6-10 years and Group III-workers with duration of lead exposure more than 10 years. Each group consisted of thirty workers. Thirty age matched healthy control subjects were taken for comparison. Demographic, occupational and clinical data were collected by using questionnaire and interview. The venous blood samples were collected from the study groups and normal healthy control group. At the time of blood collection random urine samples were collected in amber coloured bottles. The biochemical parameters were estimated by using standard assay procedures. Statistical analysis of the data was done using independent student't' test for parametric variables. Values were expressed as mean ± standard deviation (SD). P values of 0.05 or less were considered to be statistically significant. The blood lead levels and urinary lead levels of all workers were significantly increased (P < 0.001) in proportion to the duration of lead exposure as compared to controls. Systolic and diastolic blood pressure were significantly raised (P < 0.001) in all three study groups of battery manufacture workers as compared to controls. Serum Calcium, Ionized calcium, phosphorus were significantly decreased (P < 0.001) in all the three study groups. Serum vitamin D levels were lowered (P < 0.01) and serum PTH was increased (P < 0.01) in workers as compared to controls. The results of this study clearly indicate that the absorption of lead is more in these workers which adversely affects blood pressure, disturbs calcium and phosphorus metabolism which further impairs mineralization of bone resulting in decreased bone mineral density observed in these workers. Lead toxicity is still persistent in battery manufacture workers though they are using sophisticated techniques in these industries. There is a need to protect the workers from the health hazards of occupational lead exposure.

Attenuation of serum ferritin and iron burden by intake of antioxidants in beta thalassemia major.

It has been anticipated that iron and ferritin burden in patients with beta thalassemia major is associated with enhanced free radical formation and blemished antioxidant defense system. The goal of study was to scrutinize impact of serum iron, total iron binding capacity (TIBC), ferritin and erythrocyte catalase in patients with beta thalassemia major. 140 beta thalassemia major patients were studied before and after supplementation of antioxidants for one month, and status was compared with 140 age and sex matched healthy controls. A significant elevation was found in the levels of serum iron and ferritin (P < 0.001) with concomitant decrease in erythrocyte catalase (P < 0.001) in patients when compared with controls. After one month supplementation of antioxidants, catalase was elevated significantly (P < 0.001) and marginal rise in serum TIBC concentration increased marginally while iron and ferritin were decreased marginally (P > 0.05) when compared with controls and baselines values. Beta thalassemia major children receive multiple blood transfusions, and are at risk of secondary iron overload induced oxidative stress. These effects may be help to minimize with supplementation of antioxidants.

Evaluation of oxidative stress and anti-oxidant status in essential hypertension.

The present study was planned to access the role of oxidative stress and anti-oxidant status in essential hypertension. Malondialdehyde is one of the by-products of lipid peroxidase and so extent of lipid peroxidation was measured by estimating malondialdehyde levels, nitrite concentration was used as an index of nitric oxide synthesis and anti-oxidant status was measured in terms of total antioxidant capacity. One hundred and eighty cases with essential hypertension and 60 volunteers as healthy controls were selected for the study. The subjects under study were grouped as pregeriatric (35-50 years) and geriatric (51-65 years). These cases were further subdivided into group I (mild), group II (moderate) and group III (severe), depending upon the levels of blood pressure. The study results showed statistically significant increased levels of serum malondialdehyde in all the groups of essential hypertensive patients when compared to that of healthy controls (p < 0.001), whereas levels of serum nitric oxide and total anti-oxidant capacity were significantly decreased in all groups of essential hypertensive patients when compared to those of controls (p < 0.001). These clear findings of the present study focuses the attention towards an alteration in the status of oxidants and anti-oxidant parameters indicating an impact of free radical action in the pathogenesis of essential hypertension.

Biochemical effects of lead exposure on systolic & diastolic blood pressure, heme biosynthesis and hematological parameters in automobile workers of north karnataka (India).

The purpose of this study was to find out the effect of lead exposure on systolic and diastolic blood pressure, heme biosynthesis related and hematological parameters of automobile workers. For this study 30 automobile workers were selected and compared with 30 age matched healthy control subjects. Significantly increased blood lead (364%, P < 0.001) and urinary lead (176%, P < 0.001) levels were observed in automobile workers (study group) as compared to controls. Systolic blood pressure (5.32%, P < 0.05) and diastolic blood pressure (5.87%, P < 0.05) were significantly increased in the automobile workers as compared to controls. The significantly decreased non-activated erythrocyte δ-aminolevulinic acid dehydratase (δ-ALAD) (-18.51%, P < 0.01) and activated δ-ALAD (-13.29%, P < 0.05) levels were observed in automobile workers as compared to normal healthy control subjects. But the ratio of activated/non-activated δ-ALAD was significantly increased (43.83%, P < 0.001) in automobile workers as compared to controls. Excretions of δ-aminolevulinic acid (83.78%, P < 0.001) and porphobilinogen (37%, P < 0.001) in urine were significantly increased in the study group as compared to the controls. In automobile workers heamoglobin (-11.51%, P < 0.001), hematocrit (-4.06%, P < 0.05), mean corpuscle volume (-3.34%, P < 0.05), mean corpuscle hemoglobin (-5.66%, P < 0.01), mean corpuscle hemoglobin concentration (-7.67%, P < 0.001), red blood cell count (-14.6%, P < 0.001) were significantly decreased and total white blood cell count (11.44%, P < 0.05) increased as compared to the controls. The results of this study clearly indicate that the absorption of lead is more in automobile workers and it affects on blood pressure, heme biosynthesis and hematological parameters observed in this study group.

Lipid peroxidation and antioxidant vitamin status in colorectal cancer patients.

Reactive Oxygen Species (ROS) can induce carcinogenesis via DMA injury. Both enzymatic and non-enzymatic antioxidants participate in cell protection against harmful influence of oxidative stress. The aim of the present study was to assess the level of end product of lipid peroxidation such as malondialdehyde (MDA) as an oxidant in colorectal cancer. Moreover, we analyzed the activity of main non-enzymatic antioxidants, vitamin E and vitamin C in colorectal cancer patients. In the present study, total 48 samples were analyzed which includes 24 age matched healthy controls irrespective of sex (Group I) and 24 cases of colorectal cancer (Group II). The serum level of lipid peroxide, vitamin E and vitamin C were estimated in both healthy control Group I (n=24) and colorectal cancer Group II (n=24). A significant increase in the level of serum lipid peroxide (P<0.001), with concomitant decrease in the levels of serum vitamin E and vitamin C, (P<0.001) in Group II patients were noticed as compared to the healthy control Group I. Our findings suggest that increased oxidative stress and reduced antioxidants defense mechanism may play an important role in progression and pathogenesis of colorectal cancer.

Evaluation of Oxidative Stress in Type 2 Diabetes Mellitus and Follow-up Along with Vitamin E Supplementation.

Increased oxidative stress is a widely accepted participant in the development and progression of diabetes and its complications. The present study has been undertaken to evaluate oxidative stress in type 2 diabetes mellitus and effect of vitamin E supplementation on oxidative stress. In all 120 subjects were enrolled in the present study, 40 subjects are age and sex matched controls. Test group comprised of clinically diagnosed (n = 80) type 2 diabetic patients. Biochemical parameters like serum MDA, nitric oxide, superoxide dismutase, erythrocyte reduced glutathione and platelet aggregation were analyzed in control and diabetic group. Test group is further categorized as Group I (n = 40) diabetics were treated by only hypoglycemic drugs and Group II (n = 40) diabetics were treated by hypoglycemic drugs with vitamin E supplementation. All above biochemical parameters were again reassessed after 3 months follow-up in both group and its values were compared with its respective baseline levels. The study shows, reduction of oxidative stress, improvement in antioxidant enzymes and endothelial dysfunction in group II, those were on treatment of hypoglycemic drugs along with vitamin E supplementation. Hence the present study may conclude that vitamin E supplementation along with hypoglycemic drugs may be beneficial to type 2 DM patients to minimize vascular complications.

Role of oxidative stress in various stages of psoriasis.

Psoriasis is a chronic inflammatory, proliferative skin disease characterized by pathological skin lesions due to various exogenous and endogenous factors. It is associated with a number of biochemical and immunological disturbances. Recently, it has been suggested that increased reactive oxygen species (ROS) production and compromised function of antioxidant system may be involved in the pathogenesis of this disease. In the present study, 90 psoriasis patients were selected. Disease severity was assessed by psoriasis area severity index score and grouped as mild, moderate and severe (each group consists of 30 subjects) and compared with 30 healthy controls. Serum levels of malondialdehyde, nitric oxide end products and the activities of antioxidant enzymes such as erythrocyte-superoxide dismutase, catalase and total antioxidant status were investigated in these groups/subjects. As compared to controls, we found severitywise significantly increased serum malondialdehyde, nitric oxide end products with decrease in erythrocyte-superoxide dismutase activity, catalase activity and total antioxidant status in patients with psoriasis suggesting worsening of the disease. It seems to be linked with the enhancement of Reactive Oxygen Species production and decreased antioxidant potential in psoriasis.

Total antioxidant capacity and lipid peroxidation in liver transplantation.

Liver transplantation is an accepted therapy for chronic liver disease patients. These patients generally have low levels of fat soluble vitamins, which have important antioxidant roles. Therefore, this study was undertaken to investigate whether such patients had evidence of antioxidant depletion and increased lipid peroxidation before transplant and whether the subsequent ischemia and reperfusion encountered during liver transplantation have any effect on antioxidant levels and lipid peroxidation. We assessed plasma total antioxidant capacity and serum lipid peroxide in 12 patients undergoing liver transplantation and equal numbers of healthy subjects. We found that before reperfusion, antioxidant levels were significantly decreased along with significantly elevated lipid peroxidation levels as compared with healthy controls (P<0.001). On reperfusion of the liver graft, further declined values of total antioxidant accompanied with highly elevated lipid peroxidation were seen than those of pre-reperfusion samples (P<0.001). This data shows that patients undergoing liver transplant have lowered antioxidant defenses and evidence of free radical damage, which compound the additional insult of reperfusion injury. Therefore antioxidant therapy in these patients before transplantation may ameliorate the effects of reperfusion.

Nitric oxide: A useful indicator in acute allograft rejection after liver transplantation.

The aim of this study was to monitor serum nitric oxide levels at various times, intraoperatively and following liver transplantation in humans. Nitric oxide production was assessed by cadmium reduction method in 15 patients undergoing liver transplantation. We observed strong correlation between nitric oxide production and allograft rejection. Sustained rise in nitric oxide level after transplantation might provide an indication of acute allograft rejection. Therefore measurement of nitric oxide, a stable end product appears to be an excellent marker that can help in the development of strategies intended to improve graft viability and patient's survival.

Effect of antioxidants and antibiotics on levels of seminal oxidative stress in leukocytospermic infertile men.

Defective sperm function is the most common cause of infertility. A prospective study was carried out to correlate the concentration of nitrite (the stable metabolite of nitric oxide) in seminal plasma with leukocytospermia, and sperm membrane integrity. Total Fifty-seven normozoospermic subjects with and without leukocytospermia visiting the Infertility clinic at KH and MRC, Karad, were included in the present study. Semen samples were checked for sperm concentration, total sperm count, sperm motility, seminal leukocyte concentration and sperm membrane integrity as Hypoosmotic Swelling Test. Similarly the concentration of nitrite in seminal plasma was measured by Griess reaction and total antioxidant power measured as ferric reducing ability of plasma. The concentration of nitrite in seminal plasma was found to be raised with significantly increased leukocyte concentration in semen. Also significantly lowered levels of total antioxidant power along with defective sperm function was observed. Our results suggest that supplementary treatment of antioxidants with antibiotic for leukocytospermic infertile male patients may improve the sperm membrane integrity.

Depleted nitrite and enhanced oxidative stress in urolithiasis.

Crystal aggregation and retention are critical events for the formation of kidney stones. There is a close association between crystal development and free radical activity in vivo. In the present study 30 subjects presenting with urolithiasis were included. Serum levels of total lipid peroxides, nitric oxide (as nitrite), α-tocopherol, plasma ascorbic acid (vitamin C) and erythrocyte superoxide dismutase activity were measured. These findings were compared with 30 age matched control subjects irrespective of sex. Student's 't' test was applied for statistical analysis. There was a significant increase in lipid peroxides (p<0.001), where as significant decrease in nitrite (p<0.01) and α-tocopherol (p<0.001) levels were observed. Plasma ascorbate (p>0.05) and erythrocyte superoxide dismutase activity (p>0.05) was also found to be decreased but the difference was not statistically significant which suggests that oxidative stress is evident in urolithiasis with depletion in antioxidant status where as decrease in nitric oxide may be less abetting in disease condition.