Department of Surgery and Anatomy, Ribeirão Preto Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Department of Internal Medicine, Ribeirão Preto Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Pulm Circ. 2013 Dec;3(4):856-61. doi: 10.1086/674764.
This controlled, prospective, nonrandomized clinical investigation has as its chief strength the fact that it was done in humans with active disease and apparently on fairly modest therapeutic regimens. The aim was to present the results of oxidative-stress biomarkers in humans suffering from pulmonary artery hypertension (PAH). Inflammation and oxidative stress are essential in PAH with increased lipid peroxidation and reduced antioxidant defenses. Twenty-four adult patients of both sexes, with a mean age of 21 years, were subdivided into 2 groups: a control group of 12 healthy, nonsmoking volunteers and a PAH group (PAHG) of 12 volunteers with PAH receiving outpatient treatment. Oxidative stress was evaluated by plasma activity of reduced glutathione (GSH); lipid peroxidation was expressed by malondialdehyde (MDA) and lipid hydroperoxide (ferrous oxidation of xylenol orange [FOX] assay); vitamin E was measured by high-performance liquid chromatography and tumor necrosis factor-α (TNF-α) by enzyme-linked immunosorbent assay. Statistical analyses showed significant differences for (1) the TNF-α measure, with highest values in PAHG patients; (2) the plasma GSH, with lowest values in PAHG patients; (3) vitamin E, with the lowest concentrations in PAHG patients; (4) MDA measure, with highest values in PAHG patients; and (5) the lipid hydroperoxide FOX measure, with highest values in PAHG patients. In conclusion, inflammation and oxidative stress are present in patients with PAH, as confirmed by increased lipid peroxidation, reduced GSH, and low concentrations of vitamin E.
这项对照、前瞻性、非随机的临床研究的主要优势在于，它是在患有活动性疾病且接受适度治疗方案的人群中进行的。目的是报告患有肺动脉高压 (PAH) 的人群中氧化应激生物标志物的结果。炎症和氧化应激在 PAH 中至关重要，表现为脂质过氧化增加和抗氧化防御降低。24 名成年男女患者，平均年龄 21 岁，分为两组：对照组 12 名健康、不吸烟志愿者和 PAH 组（PAHG）12 名接受门诊治疗的 PAH 志愿者。氧化应激通过血浆还原型谷胱甘肽 (GSH) 活性进行评估；脂质过氧化作用通过丙二醛 (MDA) 和脂质过氧化物 (铁氧化邻甲氨基酚 [FOX] 测定法) 表达；维生素 E 通过高效液相色谱法测量，肿瘤坏死因子-α (TNF-α) 通过酶联免疫吸附测定法测量。统计分析显示以下指标存在显著差异：(1) TNF-α 测量值，PAHG 患者值最高；(2) 血浆 GSH，PAHG 患者值最低；(3) 维生素 E，PAHG 患者浓度最低；(4) MDA 测量值，PAHG 患者值最高；和 (5) 脂质过氧化物 FOX 测量值，PAHG 患者值最高。结论：PAH 患者存在炎症和氧化应激，这通过增加的脂质过氧化、降低的 GSH 和低浓度的维生素 E 得到证实。
