Srinivasan S, Pragasam V, Jenita X, Kalaiselvi P, Muthu V, Varalakshmi P
Department of Medical Biochemistry, Dr. A.L. Mudaliar Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai 600 113, India.
Clin Chim Acta. 2004 Dec;350(1-2):57-63. doi: 10.1016/j.cccn.2004.07.001.
Previous studies have shown that urogenital tuberculosis (GuTb) patients treated or untreated with regular anti-Tb regimen excrete comparatively high levels of urinary stone forming constituents than normal subjects. Enhanced oxidative stress is also considered as a prime factor that accelerates urolithiasis. The present study was aimed to determine antioxidant status and lipid peroxidation of these individuals in order to assess their risk for kidney stone formation.
GuTb patients and age-matched normal subjects were divided into four groups: I: normal subjects (n=60), II: GuTb patients a day before treatment (n=72), III: GuTb patients after treatment with isoniazid (300 mg), rifampicin (450 mg) and pyrazinamide (1.5 g) per day for 60 days (n=42), and IV: GuTb patients supplemented with vitamin E (200 mg/day) along with regular chemotherapy for 60 days (n=30). Blood was collected and tested for various markers of oxidative stress.
Increased levels of lipid peroxidation, protein carbonyls (PCO), advanced oxidative protein products (AOPP) and reduced antioxidant defenses by impairment in enzyme activities like superoxide dismutase, catalase, glutathione peroxidase, reduced glutathione and decreased plasma concentrations of non enzymatic antioxidants like vitamins C and E were observed in the treated and untreated GuTb patients.
These biochemical disparities may lead to membrane disintegrity, which is favorable for retention of mirolithis. Advocation of vitamin E enhanced the antioxidant status of the plasma, thereby preventing membrane injury, consequently reducing the risk of stone formation in urogenital tuberculosis patients, who were treated with their routine anti-tuberculosis drug regimen.
先前的研究表明，接受或未接受常规抗结核治疗方案的泌尿生殖系统结核（GuTb）患者，其尿中结石形成成分的排泄水平比正常受试者高。氧化应激增强也被认为是加速尿石症的主要因素。本研究旨在测定这些个体的抗氧化状态和脂质过氧化情况，以评估他们形成肾结石的风险。
将GuTb患者和年龄匹配的正常受试者分为四组：I组：正常受试者（n = 60）；II组：治疗前的GuTb患者（n = 72）；III组：接受异烟肼（300 mg）、利福平（450 mg）和吡嗪酰胺（1.5 g）每日治疗60天的GuTb患者（n = 42）；IV组：在常规化疗的同时补充维生素E（200 mg/天）持续60天的GuTb患者（n = 30）。采集血液并检测各种氧化应激标志物。
在接受治疗和未接受治疗的GuTb患者中，均观察到脂质过氧化、蛋白质羰基（PCO）、晚期氧化蛋白产物（AOPP）水平升高，以及超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶等酶活性受损导致抗氧化防御能力降低，还原型谷胱甘肽减少，血浆中维生素C和E等非酶抗氧化剂浓度降低。
这些生化差异可能导致膜完整性受损，这有利于微结石的存留。补充维生素E可提高血浆的抗氧化状态，从而防止膜损伤，进而降低接受常规抗结核药物治疗的泌尿生殖系统结核患者形成结石的风险。
