Oxidative stress and bone markers in plasma of patients with long-bone fixative surgery: Role of antioxidants

Abstract

<jats:p> It is well known that bone markers (e.g. osteocalcin and alkaline phosphatase) play a significant role in healing of bone fractures, whereas oxidative stress delay such healing. The present study aimed to investigate the effect of a mixture of antioxidants (vitamins A, C, E, and selenium) on oxidative stress parameters, and the levels of bone healing markers in the plasma of male patients following fixative surgery of long bones. Antioxidant tablets (300 µg vitamin A, 10 mg vitamin E, 60 mg vitamin C, and 75 µg selenium) were administered to groups 3 and 4 (10 patients in each) for 1 and 2 weeks, respectively, in addition to the regular postoperative treatment. Groups 1 (25 patients) and 2 (10 patients) received the regular post-operative treatment consisting of intravenous (I.V.) second generation of cephalosporin 1000 mg/day for 3 days, oral diclofenac 50 mg, and paracetamol 500 mg twice daily for 15 days. Osteocalcin level and alkaline phosphatase activity as well as antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), as well as glutathione (GSH), and thiobarbituric acid reactive substances (TBARS) as indices of oxidative stress, were determined in the plasma of all patients after 1 or 2 weeks of long-bone fixative surgery. The results revealed that osteocalcin level and the activity of alkaline phosphatase were markedly increased in the plasma of patients who received antioxidants for 2 weeks. In addition, after 1 and/or 2 weeks, the levels of TBARS were significantly lower in the antioxidant-treated patients compared with those who did not receive antioxidants. On the other hand, the activities of SOD and GR were markedly elevated in plasma of patients who received antioxidants after 1 or 2 weeks compared with patients who received regular therapy. Moreover, the level of plasma GSH was markedly increased only after 2 weeks in patients who received antioxidants. It is concluded that administration of antioxidant vitamins A, E, and C in addition to selenium could accelerate bone healing after long-bone fixative surgery. Therefore, antioxidants should be considered in designing therapeutic protocols in post-operative bone surgery. </jats:p>

A Mussel‐Inspired Persistent ROS‐Scavenging, Electroactive, and Osteoinductive Scaffold Based on Electrochemical‐Driven In Situ Nanoassembly

“…Finally, the PPy‐PDA NPs have long term, repeatable efficient ROS scavenging ability, which continuously controls the ROS level during inflammation in the initial stage of bone regeneration. In general, bone regeneration maintains a high ROS level for 1–2 weeks or longer after surgery . It should be noted that excessive ROS caused by inflammation is harmful to cells.…”

Acute Phase Response of Selenium Status and Glutathione Peroxidase Activity in Blood Plasma Before and After Total Knee Arthroplasty Surgery

“…Major surgeries produce ROS and induce inflammatory responses [2,3]. The significant increase in the inflammatory responses has been observed with long-bone fixative surgery [4], gastrointestinal tract surgery [5], and total hip and knee replacement surgery [6]. During inflammatory responses, ROS plays a role in the development of tissue damage and organ failure [7] through the peroxidation of the plasma membrane, the oxidation of critical enzymatic or structural proteins, and the induction of apoptosis [2,8].…”

Sequential Analysis of Oxidative Stress Markers and Vitamin C Status in Acute Bacterial Osteomyelitis

“…In vitro studies suggest that vitamin C can suppress activity and reduce the survival rate of osteoclasts [7] while enhancing the survival [8] and differentiation of osteoblasts [9]. Besides, administration of antioxidant vitamins A, E, and C was shown to accelerate bone healing after long-bone fixative surgery by diminishing oxidative injury and promoting osteogenic activity [12]. …”