RESUMO
RESUMEN Fundamento: la relación entre la forma reducida y oxidada del glutatión, GSH/GSSG, es frecuentemente utilizada como indicador del estado redox celular. En las condiciones donde se generan altos niveles de especies oxidantes, se pueden aumentar los requerimientos de glutatión reducido, y por tanto, afectarse el estado redox celular. Objetivo: determinar la relación entre el estado redox celular y marcadores sistémicos de inflamación. Métodos: se realizó un estudio descriptivo en una serie de 56 casos remitidos de la consulta de inmunogenética, en edades comprendidas entre 1 y 76 años, de ambos sexos. Se determinaron la velocidad de eritrosedimentación y los niveles séricos de proteína C-reactiva como marcadores sistémicos de inflamación. La relación GSH/GSSG se calculó a partir de las concentraciones intraeritrocitarias de glutatión reducido y su forma oxidada, las que fueron determinadas mediante un método de HPLC-UV. Resultados: la relación GSH/GSSG promedio fue de 7,9 (IC 95 %:6,4-9,4) y la edad no influyó en esta proporción. En los casos que tenían valores alterados de los marcadores de inflamación, mostraban una disminución en la relación GSH/GSSG. El estado redox celular se correlacionó negativamente con los valores de la eritrosedimentación (r=-0,41; p=0,017). Sin embargo, esta asociación no aparece cuando se analizan los niveles de proteína C-reactiva. Conclusiones: los pacientes que presentan alteraciones en los marcadores de inflamación muestran cambios en el estado redox celular. El estudio combinado de estos biomarcadores permite realizar un análisis integral del estado de salud del paciente con enfermedades inflamatorias.
ABSTRACT Background: the relationship between the reduced and oxidized form of glutathione, GSH/ GSSG, is frequently used as an indicator of the cellular redox state. Under conditions where high levels of oxidizing species are generated, reduced glutathione requirements can be increased, and therefore, the cellular redox state can be affected. Objective: to determine the relationship between the cellular redox state and systemic markers of inflammation. Methods: a descriptive study was carried out in a series of 56 cases referred from the immunogenetics clinic, aged between 1 and 76 years old, of both sexes. Erythrocyte sedimentation rate and serum levels of C-reactive protein were determined as systemic markers of inflammation. The GSH/GSSG ratio was calculated from the intraerythrocyte concentrations of reduced glutathione and its oxidized form, which were determined by an HPLC-UV method. Results: the average GSH/GSSG ratio was 7.9 (95 % CI: 6.4-9.4) and age did not influence this proportion. In the cases that had altered values of the inflammation markers, they showed a decrease in the GSH/GSSG ratio. Cellular redox status was negatively correlated with erythrocyte sedimentation values (r=0.41; p=0.017). However, this association does not appear when C-reactive protein levels are analyzed. Conclusions: the patients who present alterations in the inflammation markers show changes in the cellular redox state. The combined study of these biomarkers allows a more comprehensive analysis of the health status of patients with inflammatory diseases.
RESUMO
AIM: To investigate the efficacy of Viusid, a nutritional supplement, as an antioxidant and an immunomodulator in patients with chronic hepatitis C. METHODS: Sixty patients with chronic hepatitis C who were non-responders to standard antiviral treatment were randomly assigned to receive Viusid (3 sachets daily, n = 30) or placebo (n = 30) for 24 wk. The primary outcome was the change in serum malondialdehyde and 4-hydroxyalkenals (lipid peroxidation products). Secondary outcomes were changes in serum tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) and interleukin-10 (IL-10). RESULTS: Statistically significant reductions in serum 4-hydroxyalkenals and malondialdehyde levels were observed in both groups in comparison with pretreatment values, but the patients who received Viusid showed a more marked reduction as compared with the control group (P = 0.001). TNF-alpha levels significantly increased from 6.9 to 16.2 pg/mL (P < 0.01) in the patients who received placebo in comparison with almost unchanged levels, from 6.6 to 7.1 pg/mL (P = 0.26), in the patients treated with Viusid (P = 0.001). In addition, IL-10 levels were markedly increased in the patients treated with Viusid (from 2.6 to 8.3 pg/mL, P = 0.04) in contrast to the patients assigned to placebo (from 2.8 to 4.1 pg/mL, P = 0.09) (P = 0.01). Likewise, the administration of Viusid markedly increased mean IFN-gamma levels from 1.92 to 2.89 pg/mL (P < 0.001) in comparison with a reduction in mean levels from 1.80 to 1.68 pg/mL (P = 0.70) in the placebo group (P < 0.0001). Viusid administration was well tolerated. CONCLUSION: Our results indicate that treatment with Viusid leads to a notable improvement of oxidative stress and immunological parameters in patients with chronic hepatitis C.