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Thromb Haemost 2023; 123(12): 1129-1139
DOI: 10.1055/s-0043-1772683
Cellular Haemostasis and Platelets

Variations of Redox Balance in Different Stages of Childhood Immune Thrombocytopenic Purpura

Rasa H. Medovic 
1   Department of Pediatrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
2   University Clinical Center Kragujevac, Kragujevac, Serbia
,
Ivan M. Srejovic 
3   Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
4   Center of Excellence for the Study of Redox Balance in Cardiovascular and Metabolic Disorders, University of Kragujevac, Kragujevac, Serbia
5   Department of Pharmacology, First Moscow State Medical University I.M. Sechenov, Moscow, Russian Federation
,
Marija V. Medovic 
2   University Clinical Center Kragujevac, Kragujevac, Serbia
6   Department of Dermatovenerology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
,
Isidora M. Milosavljevic 
4   Center of Excellence for the Study of Redox Balance in Cardiovascular and Metabolic Disorders, University of Kragujevac, Kragujevac, Serbia
7   Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
,
Marina R. Nikolic 
3   Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
4   Center of Excellence for the Study of Redox Balance in Cardiovascular and Metabolic Disorders, University of Kragujevac, Kragujevac, Serbia
,
Aleksandra Z. Stojanovic 
4   Center of Excellence for the Study of Redox Balance in Cardiovascular and Metabolic Disorders, University of Kragujevac, Kragujevac, Serbia
7   Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
,
Milos B. Kuzmanovic
8   Mother and Child Health Institute of Serbia “Dr Vukan Cupic”, Belgrade, Serbia
9   Department of Pediatrics, Medical Faculty, University of Belgrade, Belgrade, Serbia
,
Predrag M. Djurdjevic 
2   University Clinical Center Kragujevac, Kragujevac, Serbia
10   Department of Internal medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
,
Sergey B. Bolevich 
11   Department of Human Pathology, First Moscow State Medical University I.M. Sechenov, Moscow, Russia Federation
,
Vladimir P. Fisenko 
5   Department of Pharmacology, First Moscow State Medical University I.M. Sechenov, Moscow, Russian Federation
,
Vladimir Lj. Jakovljevic 
3   Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
4   Center of Excellence for the Study of Redox Balance in Cardiovascular and Metabolic Disorders, University of Kragujevac, Kragujevac, Serbia
11   Department of Human Pathology, First Moscow State Medical University I.M. Sechenov, Moscow, Russia Federation
,
Zoran R. Igrutinovic 
1   Department of Pediatrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
2   University Clinical Center Kragujevac, Kragujevac, Serbia
› Author Affiliations
Funding The project was supported by Faculty of Medical Sciences, University of Kragujevac (JP 27/20) and Ministry of Science, Technical Development and Innovation of the Republic of Serbia (contract No. 451-03-47/2023-01/200111).
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Abstract

Background Few previous studies indicated the role of oxidative stress in the pathogenesis of childhood idiopathic thrombocytopenic purpura (ITP), but there are little data regarding changes in redox balance in different forms of the disease, and changes after therapeutic procedures. We aimed to investigate the values of pro-oxidants and antioxidative capacity in various forms of ITP before and after the applying therapy.

Materials and Methods The research included 102 children, classified into the following groups: (1) newly diagnosed ITP (ndITP), (2) persistent ITP, (3) chronic ITP (chITP), and (4) control groups: (A) healthy control and (B) previously experienced ITP—healthy children who had been suffering from ITP earlier. During the clinical assessment, a blood sample was taken from the patients, from which the value of pro-oxidants (index of lipid peroxidation measured as TBARS, nitrites [NO2 −], as measurement of nitric oxide [NO] production, superoxide anion radical [O2 −], and hydrogen peroxide [H2O2]) and the capacity of antioxidant protection (activity of superoxide dismutase and catalase, and quantity of reduced glutathione) were determined spectrophotometrically.

Results Our results demonstrated that values of pro-oxidants, especially reflected through the TBARS and O2 −, were the highest in the ndITP and exacerbated chITP groups. Also, the activity of the endogenous antioxidative defense system was the lowest in these groups. Intravenous immunoglobulin therapy in the ndITP group exerted the most prominent effect on the redox balance.

Conclusion It can be concluded that severity and exacerbation of the ITP are closely related to the redox status.

Keywords

childhood idiopathic thrombocytopenic purpura - corticosteroids - endogenous antioxidant - intravenous immunoglobulins - oxidative stress

Ethical Approval Statement

Parents and patients were informed about the research, and written consent was obtained from the parents, and from the patients themselves if they were older than 12 years, to participate in the research. Ethical approval was obtained from University Clinical Center Kragujevac, Kragujevac, Serbia (approval number 01-22-656).


Authors' Contribution

Conception and design of the study: R.H.M., Z.R.I., I.M.S., V.L.J.; acquisition of data: R.H.M., M.B.K., P.M.D., Z.R.I.; analysis and interpretation of data: R.H.M., I.M.S., M.V.M, I.M.M., M.R.N., A.Z.S., S.B.B., V.P.F.; drafting the article: R.H.M., I.M.S., V.L.J., A.Z.S. All authors approved the final version of the manuscript before submission.




Publication History

Received: 18 January 2023

Accepted: 02 June 2023

Article published online:
21 August 2023

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