Oxidant and Antioxidant Balance in Children with Community-Acquired Pneumonia

Abstract

Objective The balance between oxidant and antioxidant defense mechanisms is crucial. In this article, we aimed to evaluate the role of this balance in community-acquired pneumonia (CAP) in children.

Methods We analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic data of children with CAP and compared them with healthy controls. Serum total antioxidant status (TAS) and total oxidant status (TOS) were evaluated and compared between the groups, along with levels of ischemia-modified albumin (IMA), antioxidant enzymes, nonenzymatic antioxidant factors, and plasma thiol.

Results Of 160 children evaluated, 106 had CAP (54 outpatients and 52 inpatients), and the other 54 were healthy (control group). Total thiol and native thiol levels were significantly lower in the inpatient group compared with the outpatient group (p = 0.004 and p = 0.005, respectively). Serum IMA differed significantly among the groups (p = 0.001), with inpatients showing the highest level. A positive correlation was found between serum IMA and C-reactive protein levels in patients with pneumonia (r = 0.351; p = 0.001).

Conclusion Parameters that provide information about antioxidant capacity may be useful in the diagnosis and prognosis of pneumonia. Our results suggest that plasma thiol levels and IMA may be good candidate biomarkers to predict hospitalization for CAP in children.

Keywords

oxidative stress - pneumonia - children

Publikationsverlauf

Eingereicht: 12. April 2021

Angenommen: 09. Juni 2021

Artikel online veröffentlicht:
28. Juli 2021

• References

• 1 Harris M, Clark J, Coote N. et al; British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax 2011; 66 (Suppl. 02) ii1-ii23
• 2 World Health Organization. Pneumonia. WHO; 2015
• 3 Ciencewicki J, Trivedi S, Kleeberger SR. Oxidants and the pathogenesis of lung diseases. J Allergy Clin Immunol 2008; 122 (03) 456-468 , quiz 469–470
• 4 Morris D, Khurasany M, Nguyen T. et al. Glutathione and infection. Biochim Biophys Acta 2013; 1830 (05) 3329-3349
• 5 Muravlyova L, Molotov-Luchankiy V, Bakirova R, Klyuyev D, Demidchik L, Lee V. Characteristics of the oxidative stress in blood of patients in dependence of community-acquired pneumonia severity. Open Access Maced J Med Sci 2016; 4 (01) 122-127
• 6 Principi N, Esposito S. Biomarkers in pediatric community-acquired pneumonia. Int J Mol Sci 2017; 18 (02) E447
• 7 Rodosskaia NK, Chernousova GM. Immune system and thiols: some peculiarities of thiol exchange. Comp Immunol Microbiol Infect Dis 2010; 33 (01) 65-71
• 8 Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38 (12) 1103-1111
• 9 Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem 2004; 37 (04) 277-285
• 10 Ayar G, Atmaca YM, Alışık M, Erel Ö. Effects of paraoxonase, arylesterase, ceruloplasmin, catalase, and myeloperoxidase activities on prognosis in pediatric patients with sepsis. Clin Biochem 2017; 50 (7-8): 414-417
• 11 Haq IJ, Battersby AC, Eastham K, McKean M. Community acquired pneumonia in children. BMJ 2017; 356: j686
• 12 Sies H. Oxidative stress: oxidants and antioxidants. Exp Physiol 1997; 82 (02) 291-295
• 13 Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014; 47 (18) 326-332
• 14 Harma M, Harma M, Erel O. Measurement of the total antioxidant response in preeclampsia with a novel automated method. Eur J Obstet Gynecol Reprod Biol 2005; 118 (01) 47-51
• 15 Eckerson HW, Romson J, Wyte C, La Du BN. The human serum paraoxonase polymorphism: identification of phenotypes by their response to salts. Am J Hum Genet 1983; 35 (02) 214-227
• 16 Góth L. A simple method for determination of serum catalase activity and revision of reference range. Clin Chim Acta 1991; 196 (2-3): 143-151
• 17 Haagen L, Brock A. A new automated method for phenotyping arylesterase (EC 3.1.1.2) based upon inhibition of enzymatic hydrolysis of 4-nitrophenyl acetate by phenyl acetate. Eur J Clin Chem Clin Biochem 1992; 30 (07) 391-395
• 18 Bradley PP, Priebat DA, Christensen RD, Rothstein G. Measurement of cutaneous inflammation: estimation of neutrophil content with an enzyme marker. J Invest Dermatol 1982; 78 (03) 206-209
• 19 Erel O. Automated measurement of serum ferroxidase activity. Clin Chem 1998; 44 (11) 2313-2319
• 20 Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med 2000; 19 (04) 311-315
• 21 Esen R, Aslan M, Kucukoglu ME. et al. Serum paraoxonase activity, total thiols levels, and oxidative status in patients with acute brucellosis. Wien Klin Wochenschr 2015; 127 (11-12): 427-433
• 22 Stocker R, Keaney Jr JF. Role of oxidative modifications in atherosclerosis. Physiol Rev 2004; 84 (04) 1381-1478
• 23 Biswas S, Chida AS, Rahman I. Redox modifications of protein-thiols: emerging roles in cell signaling. Biochem Pharmacol 2006; 71 (05) 551-564
• 24 Gulpamuk B, Tekin K, Sonmez K. et al. The significance of thiol/disulfide homeostasis and ischemia-modified albumin levels to assess the oxidative stress in patients with different stages of diabetes mellitus. Scand J Clin Lab Invest 2018; 78 (1-2): 136-142
• 25 Kara SS, Erel O, Demirdag TB. et al. Alteration of thiol-disulphide homeostasis in acute tonsillopharyngitis. Redox Rep 2017; 22 (05) 205-209
• 26 Aycicek A, Iscan A, Erel O, Akcali M, Selek S. Total antioxidant/oxidant status in meningism and meningitis. Pediatr Neurol 2006; 35 (06) 382-386
• 27 Ozyazici S, Karateke F, Turan U. et al. A Novel Oxidative Stress Mediator in Acute Appendicitis: Thiol/Disulphide Homeostasis. Mediators Inflamm 2016; 2016: 6761050
• 28 Karadag-Oncel E, Erel O, Ozsurekci Y. et al. Plasma oxidative stress and total thiol levels in Crimean-Congo hemorrhagic fever. Jpn J Infect Dis 2014; 67 (01) 22-26
• 29 Parlak ES, Alisik M, Hezer H, Karalezli A, Hasanoglu HC, Erel O. Evaluation of dynamic thiol/disulfide redox state in community-acquired pneumonia. Saudi Med J 2018; 39 (05) 495-499
• 30 Leelarungrayub J, Borisuthibandit T, Yankai A, Boontha K. Changes in oxidative stress from tracheal aspirates sampled during chest physical therapy in hospitalized intubated infant patients with pneumonia and secretion retention. Ther Clin Risk Manag 2016; 12: 1377-1386
• 31 Chan B, Dodsworth N, Woodrow J, Tucker A, Harris R. Site-specific N-terminal auto-degradation of human serum albumin. Eur J Biochem 1995; 227 (1-2): 524-528
• 32 Cheng CW, Chien MH, Su SC, Yang SF. New markers in pneumonia. Clin Chim Acta 2013; 419: 19-25
• 33 Grover H, Saini R, Bhardwaj P, Bhardwaj A. Acute-phase reactans. Journal of Oral Research and Review. 2016; 8: 31-35
• 34 Bolatkale M, Duger M, Ülfer G. et al. A novel biochemical marker for community-acquired pneumonia: ischemia-modified albumin. Am J Emerg Med 2017; 35 (08) 1121-1125
• 35 Yerlikaya FH, Kurban S, Mehmetoglu I. et al. Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis. J Matern Fetal Neonatal Med 2014; 27 (17) 1723-1727
• 36 Park HS, Kim SR, Lee YC. Impact of oxidative stress on lung diseases. Respirology 2009; 14 (01) 27-38
• 37 Trefler S, Rodríguez A, Martín-Loeches I. et al. Oxidative stress in immunocompetent patients with severe community-acquired pneumonia. A pilot study. Med Intensiva 2014; 38 (02) 73-82
• 38 Katsoulis K, Kontakiotis T, Baltopoulos G, Kotsovili A, Legakis IN. Total antioxidant status and severity of community-acquired pneumonia: are they correlated?. Respiration 2005; 72 (04) 381-387
• 39 Van den Bruel A, Thompson MJ, Haj-Hassan T. et al. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ 2011; 342: d3082
• 40 Pohanka M. Role of oxidative stress in infectious diseases. A review. Folia Microbiol (Praha) 2013; 58 (06) 503-513
• 41 Braun J, Dalhoff K, Lipp R. et al. [Myeloperoxidase, lactoferrin and elastase in bronchoalveolar lavage and plasma in pneumonia]. Pneumologie 1992; 46 (04) 141-147
• 42 Cemek M, Caksen H, Bayiroğlu F, Cemek F, Dede S. Oxidative stress and enzymic-non-enzymic antioxidant responses in children with acute pneumonia. Cell Biochem Funct 2006; 24 (03) 269-273
• 43 Shepelenko AF, Khatskevich VL, Lishcheniuk OA, Korshunov GV, Dolmashkina MA. [The role of humoral markers of inflammation activity in the evaluation of adequacy of antibacterial chemotherapy for community-acquired pneumonia]. Voen Med Zh 2005; 326 (01) 25-30