Plasma glutathione peroxidase (GSH-Px) concentration is elevated in rheumatoid arthritis: a case-control study.

Plasma glutathione peroxidase (GSH-Px) by enzyme-linked immunosorbent assay (ELISA) offers a complimentary measurement approach to traditional GSH-Px activity methods. The aim was to investigate whether GSH-Px measured by ELISA in rheumatoid arthritis patients was elevated compared to controls. This was a case-control study with rheumatoid arthritis patients recruited from private practice and gender and age-matched controls randomly selected from the electoral role. GSH-Px concentration was measured by ELISA. Plasma malondialdehyde was used as a measure of oxidative stress, and antioxidant capacity was measured based on reduction of Cu(++) to Cu(+) by antioxidants in the sample. Disease severity was measured using the Health Assessment Questionnaire-Disability Index (HAQ-DI) and C-reactive protein was measured using an immunoturbidometric method. A total of 74 patients were recruited, consisting of 35 rheumatoid arthritis cases and 39 healthy controls. There were no differences between rheumatoid arthritis cases and controls for oxidative stress and antioxidant capacity; however, GSH-Px concentration was markedly elevated in the rheumatoid arthritis sufferers (85.9 ± 147.7 versus 17.3 ± 13.0 mg/L, respectively; mean ± SD; p < 0.01). GSH-Px levels were not associated with severity measured by the HAQ-DI or C-reactive protein. Patients with rheumatoid arthritis demonstrated increased GSH-Px consistent with an adaptive upregulation of GSH-Px to protect against oxidative stress.