OXIDATIVE STRESS AND ANTIOXIDANT SYSTEM IN TYPE I TAKAYASU ARTERITIS

Abstract

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.