Uticaj hiperbarične oksigenoterapije na redoks status bolesnika sa sistemskim eritemskim lupusom
Sažetak
Uvod/Cilj. Hiperbarična oksigenoterapija (HBOT) je metoda kojom se rastvorljivost kiseonika u plazmi povećava i do 20 puta. Taj efekat je veoma značajan u terapiji poremećaja cirkulacije koji smanjuju oksigenaciju i dovode do povećanja produkcije medijatora zapaljenja i slobodnih kiseoničkih radikala. Cilj ove studije bio je da se ispita uticaj HBOT na parametre oksidativnog stresa kod bolesnika sa sistemskim eritemskim lupusom (SLE). Metode. Prospektivnom studijom obuhvaćeno je 18 bolesnica sa SLE (kriterijumi Američkog koledža za reumatologiju) prosečne starosti 52,2 ± 8,82 godina, koje su tretirane HBOT u trajanju od 60 min/dan, pri pritisku od 2,2 apsolutne atmosfere (ATA), ukupno 10 dana, u kombinaciji sa odgovarajućom terapijom za SLE. U serumu su određivani sledeći parametri: C-reaktivni protein (CRP), hemoglobin, kreatinin, albumin, komplement 3 (C3), antinuklearna antitela (ANA), stopa glomerularne filtracije (GFR korišćenjem Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formule. U urinu su spektrofotometrijski određivani parametri oksidacionog stresa: nivo superoksid anjon radikala (O2·–), vodonik peroksida (H2O2), nitrita (NO2-) i koncentracija reaktivnih produkata tiobarbituratne kiseline (TBARS). U hemolizatu, određivani su parametri antioksidativne zaštite: aktivnost superoksid dismutaza (SOD), katalaze (CAT) i redukovani glutation (GSH). Uzorci za analize su sakupljani tri puta: pre HBOT (inicijalne vrednosti), nakon 10 dana HBOT i nakon mesec dana terapije. Rezultati. Uočili smo statistički značajno (p < 0,05) smanjenje nivoa O2·– nakon 10 dana, kao i nakon mesec dana od početka HBOT u odnosu na inicijalnu vrednost (8,26 ± 13,62; 8,39 ± 4,94 11,92 ± 6,86; nmol/mL, redom). Nisu pokazane značajne razlike u vrednostima ostalih parametara oksidativnog stresa kao što su NO2-, TBARS i H2O2 tokom posmatranog perioda. Što se tiče parametara antioksidativne zaštite, otkrili smo nešto veću vrednost GSH nakon tretmana (inicijalno 66,34 ± 16,31; posle 10 daba 79,43 ± 36,77; posle mesec dana tretmana 69,72 ± 22,32 μmol/mL eritrocita), koja se održala nakon mesec dana, ali nije bila statistički značajna. Aktivnost SOD i CAT, pre i posle HBOT, nije se statistički značajno menjala. Zaključak. Naši rezultati ukazuju na povoljan efekat HBOT na redoks ravnotežu kod bolesnika sa SLE zbog sniženja nivoa O2·–.
Reference
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