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oxidative stress in critically ill patients

Jessica A Alvarez, Jocelyn R Grunwell, Scott E Gillespie, Vin Tangpricha, Kiran B Hebbar
Critically ill populations incur high levels of oxidative stress and commonly present with vitamin D deficiency. This study aimed to investigate the relationship between vitamin D status and plasma markers of glutathione (GSH) and cysteine (Cys) redox and immunity in critically ill children. This was a cross-sectional study of n=50 PICU patients. Subjects were categorized according to their plasma 25-hydroxyvitamin D [25(OH)D] concentrations: (<20, 20-30, and ≥30ng/dL). Plasma GSH, glutathione disulfide (GSSG), Cys, and cystine (CySS) were measured with high-performance liquid chromatography, and their associated redox potentials determined (EhGSSG and EhCySS, respectively)...
September 15, 2016: Journal of Steroid Biochemistry and Molecular Biology
Suresh Kumar Verma, Venkata Naga Srikanth Garikipati, Raj Kishore
Mitochondrial dysfunction and associated oxidative stress are strongly linked to cardiovascular, neurodegenerative, and age associated disorders. More specifically cardiovascular diseases are common in patients with diabetes and significant contributor to the high mortality rates associated with diabetes. Studies have shown that the heart failure risk is increased in diabetic patients even after adjusting for coronary artery disease and hypertension. Although the actual basis of the increased heart failure risk is multifactorial, increasing evidences suggest that imbalances in mitochondrial function and associated oxidative stress play an important role in this process...
September 1, 2016: Biochimica et Biophysica Acta
Jianbo Yu, Jia Shi, Dan Wang, Shuan Dong, Yuan Zhang, Man Wang, Lirong Gong, Qiang Fu, Daquan Liu
BACKGROUND: Sepsis-associated acute lung injury remains the major cause of mortality in critically ill patients and is characterized by marked oxidative stress and mitochondrial dysfunction. Mitochondrial dynamics are indispensable for functional integrity. Additionally, heme oxygenase (HO)-1/carbon monoxide conferred cytoprotection against end-organ damage during endotoxic shock. Herein, we tested the hypothesis that HO-1/carbon monoxide played a critical role in maintaining the dynamic process of mitochondrial fusion/fission to mitigate lung injury in Sprague-Dawley rats or RAW 264...
August 30, 2016: Anesthesiology
Anis Chaari, Karim Abdel Hakim, Kamel Bousselmi, Mahmoud Etman, Mohamed El Bahr, Ahmed El Saka, Eman Hamza, Mohamed Ismail, Elsayed Mahmoud Khalil, Vipin Kauts, William Francis Casey
Sepsis and septic shock are life threatening condition associated with high mortality rate in critically-ill patients. This high mortality is mainly related to the inadequacy between oxygen delivery and cellular demand leading to the onset of multiorgan dysfunction. Whether this multiorgan failure affect the pancreas is not fully investigated. In fact, pancreatic injury may occur because of ischemia, overwhelming inflammatory response, oxidative stress, cellular apoptosis and/or metabolic derangement. Increased serum amylase and/or lipase levels are common in patients with septic shock...
July 15, 2016: World Journal of Gastrointestinal Oncology
Benjamin I Silbert, Kwok M Ho, Jeffrey Lipman, Jason A Roberts, Tomas B Corcoran, David J Morgan, Warren Pavey, Emilie Mas, Anne E Barden, Trevor A Mori
Furosemide, a loop diuretic, is used to increase urine output in patients with acute kidney injury (AKI). It remains uncertain whether the benefits of furosemide in AKI outweigh its potential harms. We investigated if furosemide influenced oxidative stress in 30 critically ill patients with AKI by measuring changes in F2-isoprostanes (F2-IsoPs), markers of in vivo oxidative stress, in plasma and urine following intravenous furosemide. Urine F2-IsoPs were higher in sepsis (p = 0.001) and increased in proportion to urine furosemide (p = 0...
September 15, 2016: Antioxidants & Redox Signaling
John H Meertens, Hans L Nienhuis, Joop D Lefrandt, Casper G Schalkwijk, Kristiina Nyyssönen, Jack J M Ligtenberg, Andries J Smit, Jan G Zijlstra, D J Mulder
BACKGROUND: Advanced glycation end products (AGEs) have been implicated in multiple organ failure, predominantly via their cellular receptor (RAGE) in preclinical studies. Little is known about the time course and prognostic relevance of AGEs in critically ill human patients, including those with severe sepsis. OBJECTIVE: 1) To explore the reliability of Skin Autofluorescence (AF) as an index of tissue AGEs in ICU patients, 2) to compare its levels to healthy controls, 3) to describe the time course of AGEs and influencing factors during ICU admission, and 4) to explore their association with disease severity, outcome, and markers of oxidative stress and inflammation...
2016: PloS One
Lavinia Melania Bratu, Alexandru Florin Rogobete, Dorel Sandesc, Ovidiu Horea Bedreag, Sonia Tanasescu, Razvan Nitu, Sonia Elena Popovici, Zorin Petrisor Crainiceanu
The patient with severe burns always represents a challenge for the trauma team due to the severe biochemical and physiopathological disorders. Although there are many resuscitation protocols of severe burn patient, systemic inflammatory response, oxidative stress, decreased immune response, infections, and multiple organ dysfunction syndromes are still secondary complications of trauma, present at maximum intensity in this type of patients. Currently there are numerous studies regarding the evaluation, monitoring, and minimizing the side effects induced by free radicals through antioxidant therapy...
July 27, 2016: Biochemical Genetics
Marek Nalos, Grant Parnell, Robert Robergs, David Booth, Anthony S McLean, Benjamin M Tang
BACKGROUND: Critical illness causes a shift away from mitochondrial metabolism towards a greater dependence on glycolysis. This metabolic shift is thought to be associated with lactic acidosis, organ dysfunction and poor clinical outcomes. The current paradigm is that low oxygen supply causes regional hypoxia, which in turn drives such a metabolic shift. In this study, we evaluated whether the shift towards glycolysis can also occur in cells where oxygen supply is plentiful. METHODS: We used circulating blood cells from non-hypoxic critically ill patients (n = 47) as a model to study cellular metabolism in a normal oxygen milieu...
December 2016: Intensive Care Medicine Experimental
Prashanth Ashok Kumar, Usha Anand
Sepsis is associated with various metabolic derangements as a consequence of inflammatory response, ischemia and oxidative stress. Four parameters of relevance are procalcitonin (PCT), ischemia modified albumin (IMA) pH and lactate. The study was carried out to highlight the concomitant occurrence of sepsis, ischemia and lactic acidosis, all of which could have deleterious effects on organ function. 26 critically ill patients with a provisional diagnosis of sepsis were the test subjects. The control group had 25 apparently healthy volunteers...
July 2016: Indian Journal of Clinical Biochemistry: IJCB
Palash Kar, Mark P Plummer, Rinaldo Bellomo, Alicia J Jenkins, Andrzej S Januszewski, Marianne J Chapman, Karen L Jones, Michael Horowitz, Adam M Deane
OBJECTIVES: The optimal blood glucose target in critically ill patients with preexisting diabetes and chronic hyperglycemia is unknown. In such patients, we aimed to determine whether a " liberal" approach to glycemic control would reduce hypoglycemia and glycemic variability and appear safe. DESIGN: Prospective, open-label, sequential-period exploratory study. SETTING: Medical-surgical ICU. PATIENTS: During sequential 6-month periods, we studied 83 patients with preexisting type 2 diabetes and chronic hyperglycemia (glycated hemoglobin, ≥ 7...
September 2016: Critical Care Medicine
W A C Kristine Koekkoek, Arthur R H van Zanten
This comprehensive narrative review summarizes relevant antioxidant mechanisms, the antioxidant status, and effects of supplementation in critically ill patients for the most studied antioxidant vitamins A, C, and E and the enzyme cofactor trace elements selenium and zinc. Over the past 15 years, oxidative stress-mediated cell damage has been recognized to be fundamental to the pathophysiology of various critical illnesses such as acute respiratory distress syndrome, ischemia-reperfusion injury, and multiorgan dysfunction in sepsis...
August 2016: Nutrition in Clinical Practice
Guobing Chen, Xiang Li, Mengbing Huang, Mei Li, Xiaoshuang Zhou, Ye Li, Jie Bai
Sepsis is the main cause of death in critically ill patients, pathogenesis of which is still unclear. The nuclear factor κB (NF-κB) inflammatory signal pathway mediated by endoplasmic reticulum stress is involved in sepsis. Thioredoxin-1 (Trx-1) is an important protein of regulating oxidative stress. It plays a crucial role in the anti-oxidation, anti-apoptosis, and anti-inflammation. However, the role and the mechanism of Trx-1 in sepsis have not been extensively studied. In the present study, we showed that the survival was longer in sepsis induced by cecal ligation and puncture in Trx-1 overexpression transgenic (Tg) mice compared with wild-type mice...
July 2016: Shock
Narmada Fernando, Shalini Wickremesinghe, Roshan Niloofa, Chaturaka Rodrigo, Lilani Karunanayake, H Janaka de Silva, A R Wickremesinghe, Sunil Premawansa, Senaka Rajapakse, Shiroma M Handunnetti
Pathogenesis of disease severity in leptospirosis is not clearly understood whether it is due to direct damage by pathogen or by adverse immune responses. Knowledge on biomarkers of oxidative stress which could be used in identifying patients with severe illness has shown to be of great value in disease management. Thus, the main aim of this study was to assess the damage to serum proteins and lipids, and their significance as biomarkers of oxidative stress in severe leptospirosis. In regions endemic for both leptospirosis and dengue, leptospirosis cases are often misdiagnosed as dengue during dengue epidemics...
2016: PloS One
Nikos V Margaritelis
Critically ill patients are under oxidative stress and antioxidant administration reasonably emerged as a promising approach to combat the aberrant redox homeostasis in this patient cohort. However, the results of the antioxidant treatments in the intensive care unit are conflicting and inconclusive. The main objective of the present review is to highlight some inherent, yet widely overlooked redox-related issues about the equivocal effectiveness of antioxidants in the intensive care unit, beyond methodological considerations...
September 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Brodie A Parent, Max Seaton, Ravi F Sood, Haiwei Gu, Danijel Djukovic, Daniel Raftery, Grant E O'Keefe
IMPORTANCE: Metabolomics is the broad and parallel study of metabolites within an organism and provides a contemporaneous snapshot of physiologic state. Use of metabolomics in the clinical setting may help achieve precision medicine for those who have experienced trauma, where diagnosis and treatment are tailored to the individual patient. OBJECTIVE: To examine whether metabolomics can (1) distinguish healthy volunteers from trauma patients and (2) quantify changes in catabolic metabolites over time after injury...
July 20, 2016: JAMA Surgery
Christine Charrueau, Christophe Moinard, Saskia Brinkmann, Caroline Choisy, Marie-José Butel, Michel-Francis Bureau, Servane Le Plénier, Françoise Brignole-Baudouin, Nathalie Neveux, Luc Cynober, Jean-Pascal De Bandt
Immune-enhancing diet (IED) utilization in critically ill septic patients is still debated. A new concept of IED has been proposed combining extra glutamine sequentially with either antioxidants or other amino acids, in order to match patient requirements according to their response to injury. We evaluated whether this new IED elicits a more favorable response to stress when compared with two existing IEDs both enriched in arginine but with different levels of anti-oxidants, in a validated rat model combining head injury (HI) and infectious complications...
April 24, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Subbiah Pugazhenthi, Limei Qin, P Hemachandra Reddy
Cognitive decline in chronic diabetic patients is a less investigated topic. Diabetes and obesity are among the modifiable risk factors for Alzheimer's disease (AD), the most common form of dementia. Studies have identified several overlapping neurodegenerative mechanisms, including oxidative stress, mitochondrial dysfunction, and inflammation that are observed in these disorders. Advanced glycation end products generated by chronic hyperglycemia and their receptor RAGE provide critical links between diabetes and AD...
May 5, 2016: Biochimica et Biophysica Acta
Ovidiu Horea Bedreag, Dorel Sandesc, Sorin Dan Chiriac, Alexandru Florin Rogobete, Alina Carmen Cradigati, Mirela Sarandan, Raluca Dumache, Radu Nartita, Marius Papurica
BACKGROUND: The diversity of primary and secondary traumatic injuries specific for the critically ill polytrauma patient is complicating the therapeutic management in the absence of a strict assessment of the biological changes. Inflammation, redox imbalance, and immunosuppression can be quantified by various biochemical parameters; however, they do not fully respond to the current requirements. Another phenomenon responsible for worsening the clinical status and for the development of complications in such patients is oxidative stress...
2016: Clinical Laboratory
Sanchari Roy, Fabian Benz, Jan Alder, Heike Bantel, Joern Janssen, Mihael Vucur, Jeremie Gautheron, Anne Schneider, Florian Schüller, Sven Loosen, Mark Luedde, Alexander Koch, Frank Tacke, Tom Luedde, Christian Trautwein, Christoph Roderburg
miR-192-5p has gained increasing relevance in various diseases, however, its function in acute liver injury is currently unknown. We analysed miR-192-5p serum levels and hepatic miR-192-5p expression in mice after hepatic ischaemia and reperfusion (I/R) as well as in toxic liver injury. On a functional level, miRNA levels were analysed in the different hepatic cell-compartments and in the context of tumour necrosis factor (TNF)-dependent liver cell death. We detected increased serum levels of miR-192-5p after hepatic I/R- and carbon tetrachloride (CCl4)-induced liver injury...
July 1, 2016: Clinical Science (1979-)
Prathima Nandivada, Gillian L Fell, Amy H Pan, Vania Nose, Pei-Ra Ling, Bruce R Bistrian, Mark Puder
Dietary strategies to alter the immune response to acute inflammation have the potential to improve outcomes in critically ill patients. A eucaloric ketogenic diet (EKD), composed predominantly of fat with very small amounts of carbohydrate, can provide adequate caloric support while minimizing spikes in blood glucose and reducing oxidative stress. The purpose of this study was to evaluate the effects of an EKD on glycemic control and the inflammatory response after acute endotoxemia in mice. Mice received either an EKD or a carbohydrate-based control diet (CD) for 4 weeks...
June 2016: Lipids
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