Henoch-schönlein vaskülitli çocuklarda oksidasyon ve antioksidan kapasite
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2017
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info:eu-repo/semantics/openAccess
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Henoch-Schönlein Vaskülitli Çocuk Hastalarda Oksidasyon ve Antioksidan Kapasite Henoch-schönlein purpura (HSP) vasküliti çocukluk çağında en sık görülen vaskülittir. Oksidatif hasar çeşitli inflamatuar, toksik, reperfüzyon hasarını kapsar ve reaktif oksijen molekülleri tarafından başlatılır. Hastalığın aktif döneminde HSP'li çocukların oksidan/antioksidan dengesinde olabilecek değişiklikleri incelemek amacıyla çalışma planlandı. Dicle Üniversitesi Hastanesi, Çocuk Hastalıkları Kliniğine başvuran 29 HSP'li çocuk hasta ve 30 sağlıklı çocuk çalışmaya dahil edildi. Tam kan, biyokimya, IgA, C3, C4, anti- streptolizin-O (ASO), C-reaktif protein (CRP), sedimantasyon hızı ve kan basıncı değerleri ölçüldü. Oksidatif stres/antioksidan belirteçlerinden serum katalaz, total antioksidan aktivite (TAOA), malondialdehid (MDA) ve HSP'de ilk kez paraoksonaz düzeyi ölçüldü. Çalışmaya alınan hasta ve kontrol grubu arasında biyokimyasal parametrelerde ve en önemli antioksidanlardan olan serum albümini bakımından anlamlı farklılık saptanmadı (P>0.05). Hasta grubunda %51 hastada IgA yüksekliği, %6.8 hastada C3 yüksekliği vardı. Hastaların %31'inde belirgin lökositoz (beyaz küre sayısı>15.000/mm3) ve %48'inde trombositoz (trombosit sayısı>400.000mm3) saptandı. Ayrıca, hastaların %24'ünde yüksek ASO titresi, %17'sinde CRP pozitifliği ve %79'unda sedimantasyon yüksekliği mevcuttu. Akut faz reaktanlarının yükselmesi hastalığın aktif fazında ölçülmeleriyle ilişkilendirildi. Hastaların %58'inde gastro-intestinal sistem, %48'inde eklem, %45'inde renal tutulum vardı. Hastalardaki bu değişik organ tutulumları ile oksidan ve antioksidan parametrelerin düzeyleri arasında direkt bir ilişki saptanmadı. HSP'li çocuklar, kontrollere nazaran anlamlı daha düşük katalaz (sırasıyla, 49.7±27.5 ve 68.3±21.4 IU/L, P=0.004), TAOA (sırasıyla, 0.52±0.12 ve 0.69±0.13 mmol Trolox Equival/L, P<0.001) ve Paraoksonaz (sırasıyla, 97.5±48.4 ve 135.9±95.2 U/L, P=0.047) düzeylerine sahipti. Ancak HSP'li çocuklar, kontrollerden anlamlı yüksek ortalama serum MDA düzeyine (sırasıyla, 15.4±7.34 ve 7.80±3.88 nmol/L, P<0.001) sahipti. Sonuç olarak HSP'li çocukların aktif döneminde TAOA, katalaz ve paraoksonaz düzeyleri düşmekte, lipit peroksidasyon ürünü olan MDA düzeyi artmaktadır. HSP'nin aktif döneminde lipit peroksidasyonunu kompanse edebilecek antioksidan enzimlerin düzeylerinde artış olmadığı gibi azalma olduğu görüldü. Gelecekte, mevcut tedavilere ek olarak, antioksidanların HSP tedavisindeki rolü araştırılabilir. Anahtar Kelimeler: Henoch-Schönlein purpura, katalaz, malondialdehid, antioksidan kapasite, paraoksonaz
Oxidation and antioxidant capacity in children with Henoch-Schönlein vasculitis Henoch-Schönlein purpura (HSP) vasculitis is one of the most frequent form of vasculitis in children. Oxidative damage comprises various inflammatory, toxic and reperfusion injuries and is initiated by reactive oxygen molecules. In this study, we aimed to evaluate alterations of the oxidant/anti-oxidant balance in the active phase of childhood HSP. A total of 29 children with HSP, who applied to Dicle University Hospital, Department of Pediatrics, and 30 matched healthy controls were enrolled. Complete blood counts, serum biochemistry, IgA, complement factors 3 and 4, anti-streptolysin-O (ASO), C- reactive protein (CRP), erythrocyte sedimentation rate (ESR) and blood pressures were measured. In order to evaluate oxidant/anti-oxidant balance; serum catalase, total anti-oxidant activity (TAOA), malondialdehyde (MDA) and paraoxonase levels (as a first time for HSP) were measured. There were no differences in the biochemical results between patients and controls (P>0.05). In patient group, elevated IgA levels were detected in 51% of patients and elevated C3 in 6.8%. Moderate leukocytosis (WBC>15.000/mm3) were found in 31% and thrombocytosis (Platelet counts>400.000/mm3) in 48%. Furthermore, elevated ASO were found in 24%, positive CRP in 17% and increased ESR in 79% of patients. Increased acute phase reactants were considered to be related to their measurements during active disease. There was gastro-intestinal involvement in 58% of patients, joint involvement in 48% and renal involvement in 45% of patients. No significant correlations were found between different organ involvements and the levels of oxidant/antioxidants (P>0.05). Children with HSP had significantly lower catalase (49.7±27.5 vs. 68.3±21.4 IU/L, respectively, P=0.004), TAOA (0.52±0.12 vs. 0.69±0.13 mmol Trolox Equival/L, P<0.001) and Paraoxonase (97.5±48.4 vs. 135.9±95.2 U/L, P=0.047) compared with healthy controls. However, the mean MDA levels of HSP patients were significantly lower than that of controls (15.4±7.34 vs. 7.80±3.88 nmol/L, respectively, P<0.001). In conclusion; TAOA, catalase and paraoxonase levels were found to be decreased and MDA levels increased in the active phase of childhood HSP. The levels of antioxidant enzymes (catalase and paraoxonase) did not increase as a compansation against increased lipid peroxidation. The role of antioxidants in the management of childhood HSP remains to be investigated in future. Key Words: Henoch-Schönlein purpura, catalase, malondialdehyde, antioxidant capacity, paraoxonase
Oxidation and antioxidant capacity in children with Henoch-Schönlein vasculitis Henoch-Schönlein purpura (HSP) vasculitis is one of the most frequent form of vasculitis in children. Oxidative damage comprises various inflammatory, toxic and reperfusion injuries and is initiated by reactive oxygen molecules. In this study, we aimed to evaluate alterations of the oxidant/anti-oxidant balance in the active phase of childhood HSP. A total of 29 children with HSP, who applied to Dicle University Hospital, Department of Pediatrics, and 30 matched healthy controls were enrolled. Complete blood counts, serum biochemistry, IgA, complement factors 3 and 4, anti-streptolysin-O (ASO), C- reactive protein (CRP), erythrocyte sedimentation rate (ESR) and blood pressures were measured. In order to evaluate oxidant/anti-oxidant balance; serum catalase, total anti-oxidant activity (TAOA), malondialdehyde (MDA) and paraoxonase levels (as a first time for HSP) were measured. There were no differences in the biochemical results between patients and controls (P>0.05). In patient group, elevated IgA levels were detected in 51% of patients and elevated C3 in 6.8%. Moderate leukocytosis (WBC>15.000/mm3) were found in 31% and thrombocytosis (Platelet counts>400.000/mm3) in 48%. Furthermore, elevated ASO were found in 24%, positive CRP in 17% and increased ESR in 79% of patients. Increased acute phase reactants were considered to be related to their measurements during active disease. There was gastro-intestinal involvement in 58% of patients, joint involvement in 48% and renal involvement in 45% of patients. No significant correlations were found between different organ involvements and the levels of oxidant/antioxidants (P>0.05). Children with HSP had significantly lower catalase (49.7±27.5 vs. 68.3±21.4 IU/L, respectively, P=0.004), TAOA (0.52±0.12 vs. 0.69±0.13 mmol Trolox Equival/L, P<0.001) and Paraoxonase (97.5±48.4 vs. 135.9±95.2 U/L, P=0.047) compared with healthy controls. However, the mean MDA levels of HSP patients were significantly lower than that of controls (15.4±7.34 vs. 7.80±3.88 nmol/L, respectively, P<0.001). In conclusion; TAOA, catalase and paraoxonase levels were found to be decreased and MDA levels increased in the active phase of childhood HSP. The levels of antioxidant enzymes (catalase and paraoxonase) did not increase as a compansation against increased lipid peroxidation. The role of antioxidants in the management of childhood HSP remains to be investigated in future. Key Words: Henoch-Schönlein purpura, catalase, malondialdehyde, antioxidant capacity, paraoxonase
Açıklama
Anahtar Kelimeler
Henoch-Schönlein purpura, Katalaz, Malondialdehid, Antioksidan kapasite, Paraoksonaz, Catalase, Malondialdehyde, Antioxidant capacity, Paraoxonase
