Deska Mariusz, Romuk Ewa, Segiet Oliwia Anna, Buła Grzegorz, Truchanowski Witold, Stolecka Dominika, Birkner Ewa, Gawrychowski Jacek
School of Medicine with the Division of Dentistry, Department of General and Endocrine Surgery, Medical University of Silesia, Bytom, Poland.
School of Medicine with the Division of Dentistry, Department of Biochemistry, Medical University of Silesia, Zabrze, Poland.
Eur Surg. 2017;49(3):118-126. doi: 10.1007/s10353-016-0457-6. Epub 2016 Dec 14.
The inappropriate elevation of parathormone (PTH), which regulates the process of angiogenesis in parathyroid tissue, causes the changes of activity of enzymes responsible for the removal of free radicals. Parathyroidectomy (PTX) in patients with primary hyperparathyroidism (PHPT) lowers the level of PTH and leads to the reduction of risk of cardiovascular and all-cause mortality by normalization of the antioxidant status. Therefore, the aims of the study were to assess the activity of antioxidant enzymes and free radical reaction products in patients after parathyroidectomy, and to evaluate the correlation between the systemic oxidative stress and angiogenic parameters.
Patients with PHPT treated surgically were enrolled into the study. Total antioxidant capacity (TAC), total oxidative status (TOS), oxidative stress index (OSI), superoxide dismutase (SOD), ceruloplasmin (CER), lipid hydroperoxides (LHP) and malondialdehyde (MDA) were measured before and after parathyroidectomy. The immunohistological expression of angiogenic factors in parathyroid specimens was assessed by the BrightVision method from ImmunoLogic using murine monoclonal anti-human: anti-VEGF, anti-CD31 and anti-CD106 antibodies.
The significant increase of TAC, CER, reduction of TOS, MDA, SOD, especially for cytoplasmic form, and significant decrease of OSI, LHP were observed after PTX. There was no significant correlation between changes of oxidative stress markers and angiogenic parameters: VEGF, CD-31, CD-106 in parathyroid tissue. The correlation level was low and medium.
Parathyroidectomy causes down-regulation of lipid peroxidation processes and leads to reduction of oxidative stress in patients with PHPT. The decrease in the OSI is the results of down-regulation of oxidative stress in the postoperative period. The change of the antioxidant status has no impact on angiogenesis processes in parathyroid tissue.
甲状旁腺激素（PTH）的不适当升高会调节甲状旁腺组织中的血管生成过程，导致负责清除自由基的酶的活性发生变化。原发性甲状旁腺功能亢进症（PHPT）患者进行甲状旁腺切除术（PTX）可降低PTH水平，并通过使抗氧化状态正常化来降低心血管疾病风险和全因死亡率。因此，本研究的目的是评估甲状旁腺切除术后患者抗氧化酶和自由基反应产物的活性，并评估全身氧化应激与血管生成参数之间的相关性。
纳入接受手术治疗的PHPT患者。在甲状旁腺切除术前和术后测量总抗氧化能力（TAC）、总氧化状态（TOS）、氧化应激指数（OSI）、超氧化物歧化酶（SOD）、铜蓝蛋白（CER）、脂质过氧化氢（LHP）和丙二醛（MDA）。使用来自ImmunoLogic的BrightVision方法，用鼠单克隆抗人：抗VEGF、抗CD31和抗CD106抗体评估甲状旁腺标本中血管生成因子的免疫组织化学表达。
PTX后观察到TAC、CER显著增加，TOS、MDA、SOD（尤其是细胞质形式）显著降低，OSI、LHP显著降低。甲状旁腺组织中氧化应激标志物的变化与血管生成参数VEGF、CD - 31、CD - 106之间无显著相关性。相关水平为低和中等。
甲状旁腺切除术导致脂质过氧化过程下调，并导致PHPT患者氧化应激降低。OSI的降低是术后氧化应激下调的结果。抗氧化状态的变化对甲状旁腺组织中的血管生成过程没有影响。
