A 24 h Delay in the Redox Response Distinguishes the most Severe Stroke Patients from Less Severe Stroke Patients

Abstract

Objective: Admission measures of stroke severity are often used to assess 30-90 day outcomes. Since some patients have a poor outcome by discharge, we sought to identify a biomarker that distinguishes severities as well as acute outcomes. Disruptions in the equilibrium of the redox system were used as an indicator of stroke severity and acute outcome. Methods: Oxidation reduction potential (ORP), a measure of the redox system, was assessed in plasma at admission and 24 h later in patients admitted with stroke symptoms (n=76). Overall differences in ORP between stroke patients and healthy controls were determined. Within stroke patients, changes in ORP as a function of hospital discharge status, modified Rankin scale and NIHSS were assessed using ANOVA and the ability to predict acute outcome in ischemic stroke patients based on ORP was compared to NIHSS using Receiver Operator Characteristics. Results: Stroke patients had higher ORP levels than healthy controls (p<0.05). Patients discharged to hospice or who died had significantly lower values at admission than those discharged to home or intermediate care facilities (p<0.05). However, in the following 24 h, these patients significantly increased their ORP measures (p<0.05). An ORP value >146.6 mV at admission was associated with a 46 fold increased odds of a good acute outcome. Conclusion: ORP measured at admission identified patients which died or were discharged to hospice based on their lower ORP values. The lower ORP and subsequent increase 24 h later in the most severely affected patients may reflect a failure or a delay in engaging the redox system, a response that may, during acute stages, be beneficial.

Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility

“…ORP, also known as the redox balance, is a direct measure of OS as it describes the relative proportions of oxidants (ROS) to reductants (antioxidants). Previous clinical studies have been successful in evaluating ORP in the blood of patients with traumatic brain injury, stroke, metabolic syndrome, liver toxicity, sepsis, and exercise-induced OS [ 23 24 25 26 27 28 29 30 31 ]. ORP measurement has recently been tested in human semen by a number of andrology laboratories to determine whether it is a reliable indicator of OS.…”

Semen quality and infertility status can be identified through measures of oxidation-reduction potential

“…Recently, the development of a novel technology has removed the limitations by creating a single‐use electrode sensor that requires only 30 μl of sample. This has allowed expansion into biomedical fields in which oxidative stress is suspected (Agarwal, Sharma, Roychoudhury, Du Plessis, & Sabanegh, ; Bjugstad, Rael, et al., ; Bjugstad, Fanale, ; Rael, Bar‐Or, Kelly, Carrick, & Bar‐Or, ).…”

Poor acute outcome in congestive heart failure is associated with increases in the plasma static oxidation–reduction potentials (sORP) in men but not in women

“…Therefore, measures of ORP provide a relative indicator of the balance between all pro-and anti-oxidants which, consistent with the recent definitions, is indicative of oxidative stress [3,26,27]. ORP has traditionally been used in water quality testing [28][29][30] but has also been applied to medical biologics for assessing relative change in oxidative stress [23,[31][32][33][34][35][36][37][38]. In the current study, we used ORP as an indicator of relative plasma oxidative stress to illuminate potential differences between men and women hospitalized for CHF.…”

“…ORP was measured using the RedoxSYS System (Aytu BioScience, Englewood, CO U.S.A.) using previously described methods for biological samples [31,38]. ORP was measured using excess blood plasma taken during routine daily blood draws as part of standard care.…”