The results revealed a systemic pro-oxidant status in DS individuals, evidenced by the increased activity of some important antioxidant enzymes, together with decreased GSH levels in whole blood and elevated UA levels in plasma, probably as an antioxidant compensation related to the redox imbalance in DS individuals.
BackgroundChagas disease is still an important endemic disease in Brazil, and the
cardiac involvement is its more severe manifestation. ObjectiveTo verify whether the concomitant use of carvedilol will enhance the
antioxidant effect of vitamins E and C in reducing the systemic oxidative
stress in chronic Chagas heart disease. MethodsA total of 42 patients with Chagas heart disease were studied. They were
divided into four groups according to the modified Los Andes classification:
10 patients in group IA (normal electrocardiogram and echocardiogram; no
cardiac involvement); 20 patients in group IB (normal electrocardiogram and
abnormal echocardiogram; mild cardiac involvement); eight patients in group
II (abnormal electrocardiogram and echocardiogram; no heart failure;
moderate cardiac involvement); and four patients in group III (abnormal
electrocardiogram and echocardiogram with heart failure; severe cardiac
involvement). Blood levels of markers of oxidative stress were determined
before and after a six-month period of treatment with carvedilol, and six
months after combined therapy of carvedilol with vitamins E and C. The
markers analyzed were as follows: activities of superoxide dismutase,
catalase, glutathione peroxidase, glutathione S-transferase and reductase,
myeloperoxidade and adenosine deaminase; and the levels of reduced
glutathione, thiobarbituric-acid reactive substances, protein carbonyls,
vitamin E, and nitric oxide. ResultsAfter treatment with carvedilol, all groups showed significant decrease in
protein carbonyls and reduced glutathione levels, whereas nitric oxide
levels and adenosine activity increased significantly only in the less
severely affected group (IA). In addition, the activity of most of the
antioxidant enzymes was decreased in the less severely affected groups (IA
and IB). By combining the vitamins with carvedilol, a reduction in protein
damage, in glutathione levels, and in the activity of most of the
antioxidant enzymes were observed. ConclusionsThe decrease in oxidative stress levels observed by means of the markers
tested was more significant when carvedilol was used in combination with the
antioxidant vitamins. The findings suggest that both carvedilol alone and in
combination with the vitamins were effective in attenuating the systemic
oxidative stress in patients with Chagas heart disease, especially those
less severely affected, thus suggesting the possibility of synergism between
these compounds.
Coronavirus disease 2019 (COVID-19) is a respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and marked by an intense inflammatory response and immune dysregulation in the most severe cases. In order to better clarify the relationship between peripheral immune system changes and the severity of COVID-19, this study aimed to evaluate the frequencies and absolute numbers of peripheral subsets of neutrophils, monocytes, and dendritic cells (DCs), in addition to quantifying the levels of inflammatory mediators. One hundred fifty-seven COVID-19 patients were stratified into mild, moderate, severe, and critical disease categories. The cellular components and circulating cytokines were assessed by flow cytometry. Nitric oxide (NOx) and myeloperoxidase (MPO) levels were measured by colourimetric tests. COVID-19 patients presented neutrophilia, with signs of emergency myelopoiesis. Alterations in the monocytic component were observed in patients with moderate to critical illness, with an increase in classical monocytes and a reduction in nonclassical monocytes, in addition to a reduction in the expression of HLA-DR in all subtypes of monocytes, indicating immunosuppression. DCs, especially plasmacytoid DCs, also showed a large reduction in moderate to critical patients. COVID-19 patients showed an increase in MPO, interleukin (IL)-12, IL-6, IL-10, and IL-8, accompanied by a reduction in IL-17A and NOx. IL-10 levels ≥14 pg/ml were strongly related to the worst outcome, with a sensitivity of 78•3% and a specificity of 79•1%. The results of this study indicate the presence of systemic
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