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The spontaneous and the stimulated extracellular generation of reactive oxygen species (ROS) by peripheral phagocytes, the blood antioxidant capacity and the degree of oxidative damage were evaluated in patients with severe ischemic and hemorrhagic stroke in the chronic phase of disease. It was found in patients compared to the control group that: (i) the spontaneous phagocyte oxidative activity was enhanced independently of the type of stroke and the time elapsed after stroke onset; (ii) there was no difference in the extracellular ROS generation stimulated by opsonin-dependent and independent receptor mechanisms; (iii) there was no change in the indices of blood antioxidant capacity; (iv) the concentration of plasma lipid peroxides was enhanced regardless of the type of stroke, but it significantly increased over time; and (v) the concentration of blood thiobarbituric acid-reactive material was also enhanced. It was independent of the type of stroke and remained elevated during the whole period studied. We have demonstrated an enhanced spontaneous phagocyte oxidative activity and oxidative damage to lipids in patients in the chronic phase after stroke. The elimination of generated ROS and products of lipid peroxidation from the circulation could prevent the aggravation of chronic vascular injury in patients and could reduce the possibility of a subsequent stroke. This suggests the need for complex therapy, including antioxidant treatment directed to exclude the effects of free radicals, after the oxidative stress of stroke.

The activity of peripheral phagocytes to generate reactive oxygen species (ROS) was studied in healthy individuals and patients with ischaemic stroke. The aim was to clarify the relationship between phagocyte activity, the time elapsed after the onset of disease and stroke severity. The total and extracellular production of ROS were evaluated by luminol chemiluminescence. Simultaneously the plasma oxidant activity was determined. When stimulated by opsonized zymosan, phagocytes in patients with stroke (regardless of its severity) showed fast activation. The total ROS generation increased over time in all stroke cases studied. However, the extracellular ROS generation was found to be greater in patients with severe stroke than in those with mild neurological deficiency. When stimulated by formyl-methionyl-leucyl-phenylalanine, the total oxidative phagocyte capacity (regardless of stroke severity) increased over time, but there was no change in the amount of extracellularly generated ROS. In patients with stroke the oxidant activity of plasma was enhanced. We conclude that circulating phagocytes in patients with ischaemic stroke are primed for enhanced ROS production by opsonin receptor-mediated stimulation and for increased secretion of myeloperoxidase by opsonin receptor-independent stimulation. The enhanced extracellular generation of ROS through opsonin receptor-dependent stimulation may be considered an oxidative stress biomarker in cerebral ischaemia.

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Summary. The activities of superoxide dismutase, catalase and glutathione peroxidase, and the level of reduced glutathione, were measured in heavy metal-treated erythrocytes. The hemolytic metals were found to significantly deactivate both catalase and glutathione peroxidase and to decrease the level of reduced glutathione, thus providing suitable conditions for the development of peroxidation.

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The effects of piroxicam on the production of reactive oxygen species by stimulated phagocytes was studied in whole blood by a chemiluminescence (CL) technique in relation to maximum activity, localization and kinetics of radical generation. We found that piroxicam dose-dependently inhibited total (intra- and extracellular) zymosan-stimulated luminol CL (LCL) at a high stimulant concentration (p = 0.0001). Piroxicam additionally decreased cytochalasin B-reduced LCL, which shows that the effect of the drug should be sought in the extracellular component of the response. Piroxicam inhibited the first phase of extracellular LCL in a dose-dependent manner (p = 0.0001) and revealed itself as an enhancing agent of CL in later time intervals after the start of respiratory burst, in a model system containing horseradish peroxidase (HRP) and sodium azide. It enhanced LCL of a cell-free system, i.e. influenced the CL due to HRP-catalysed decomposition of hydrogen peroxide. It also dose-dependently inhibited the early extracellular superoxide production, evaluated by lucigenin CL (p = 0.022). Piroxicam inhibited the total fMLP-stimulated LCL by 70% approximately and, only by about 30%, the first phase of fMLP-stimulated extracellular LCL, which presupposes an effect on myeloperoxidase-catalysed formation of hypochloric acid. Piroxicam slightly increased the intracellular LCL by phagocytes (p = 0.02), an effect that is probably connected with its ability to induce the release of secondary messengers in signal transduction. In conclusion, the anti-inflammatory effect of piroxicam is probably related to the inhibition of the extracellular generation of superoxide and hypochloric acid in the early stages of phagocyte activation.

Aim. To assess the association between the 12-month dynamics of cardiovascular risk factors (CVD RFs), progressing chronic kidney disease (CKD), and individual baseline clinical and laboratory parameters in patients with arterial hypertension (AH) and Type 2 diabetes mellitus (DM-2) who received active antidiabetic treatment.Material and methods. In total, 122 patients with AH and DM-2 underwent the laboratory assessment of blood and urine samples at baseline and 12 months later, in order to evaluate the levels and dynamics of CVD RFs and CKD severity.Results. After 12 months of continuous therapy with antihypertensive and oral antidiabetic medications and statins, the carbohydrate metabolism parameters significantly improved. However, creatinine clearance decreased significantly (by 7,52%). The direction of renal function parameter changes was determined by the baseline CKD stage. Progressing CKD was also associated with obesity (O), atrial fibrillation (AF), and myocardial infarction (MI) in medical history. In patients with or without O, the albumin-creatinine ratio decreased by 59,8% and 34%, respectively. In participants with or without AF, microalbuminuria increased by 321% and decreased by 53,5%, respectively. In patients with MI in medical history, urine levels of creatinine decreased by 33,6%, while in the other patients, they increased by 5,4%. O was associated with a reduction in total cholesterol (TCH) by 5,5%, while in non-obese patients, TCH levels did not change substantially.Conclusion. In most patients with AH and DM-2, adequate glycemia control, standard antihypertensive treatment, and statin therapy for 12 months were associated with minimal changes in CVD RFs and with a significant deterioration in renal function. The latter was predicted by the CKD stage at baseline, O, MI in medical history, and AF.