Garre-Morata Laura, de Haro Tomás, Villén Raquel González, Fernández-López María Luisa, Escames Germaine, Molina-Carballo Antonio, Acuña-Castroviejo Darío
UGC of Laboratorios Clínicos, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain.
Ibs.Granada, 18016 Granada, Spain.
Antioxidants (Basel). 2024 Jan 12;13(1):92. doi: 10.3390/antiox13010092.
Although ADHD is one of the most prevalent diseases during childhood, we still do not know its precise origin; oxidative/nitrosative stress and the hypothalamic-pituitary-adrenal axis are suggested contributors. Methylphenidate, among others, is the main drug used in ADHD patients, but its effects on relevant markers and structures remain unclear. This study, involving 59 patients diagnosed with ADHD according to DSM-5 criteria, aimed to assess changes in cortisol levels (using cortisol awakening response, CAR) and oxidative/nitrosative status with the treatment. Blood samples before and 3 months after treatment with methylphenidate were used to measure oxidative and inflammatory markers, as well as the endogenous antioxidant activity, while saliva samples tracked cortisol awakening response (CAR). The results showed a treatment-related improvement in the redox profile, with the reduction in advanced oxidation protein products (AOPP), lipid peroxidation (LPO), and nitrite plus nitrate (NOx) levels, and the increase in the enzymatic activities of glutathione reductase (GRd) and catalase (CAT). Moreover, the area under the curve (AUC) of CAR increased significantly, indicating increased reactivity of the HPA axis. These results support, for the first time, the involvement of the endogenous antioxidant system in the pathophysiology of ADHD.
尽管注意力缺陷多动障碍（ADHD）是儿童期最常见的疾病之一，但我们仍不清楚其确切病因；氧化/亚硝化应激和下丘脑-垂体-肾上腺轴被认为是可能的致病因素。哌甲酯是治疗ADHD患者的主要药物之一，但其对相关标志物和结构的影响尚不清楚。本研究纳入了59例根据DSM-5标准诊断为ADHD的患者，旨在评估治疗过程中皮质醇水平（采用皮质醇觉醒反应，CAR）以及氧化/亚硝化状态的变化。使用哌甲酯治疗前及治疗3个月后的血样来测量氧化和炎症标志物以及内源性抗氧化活性，同时采集唾液样本追踪皮质醇觉醒反应（CAR）。结果显示，氧化还原状态呈现与治疗相关的改善，晚期氧化蛋白产物（AOPP）、脂质过氧化（LPO）以及亚硝酸盐加硝酸盐（NOx）水平降低，谷胱甘肽还原酶（GRd）和过氧化氢酶（CAT）的酶活性增加。此外，CAR的曲线下面积（AUC）显著增加，表明下丘脑-垂体-肾上腺轴（HPA轴）反应性增强。这些结果首次证实内源性抗氧化系统参与了ADHD的病理生理过程。
