Oxidative stress precedes peak systemic inflammatory response in pediatric patients undergoing cardiopulmonary bypass operation

Christen, Stephan; Finckh, Barbara; Lykkesfeldt, Jens; Gessler, Peter; Frese-Schaper, Manuela; Nielsen, Peter; Schmid, Edith R.; Schmitt, Bernhard

doi:10.1016/j.freeradbiomed.2005.01.016

Cited by 92 publications

(69 citation statements)

References 41 publications

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“…Being placed low in the antioxidant hierarchy (4), ascorbate is considered a biomarker of oxidative stress and offers a general indication of the antioxidant status of an individual. Increased DHA, on the other hand, more specifically suggests a redox imbalance and inadequate recycling capacity (5)(6)(7). However, although a considerable body of epidemiologic literature suggests an inverse correlation between plasma ascorbate and the risk of developing cancer and cardiovascular disease, controlled trials have thus far been unsuccessful in showing the health benefits of vitamin C supplementation (1).…”

Section: Introductionmentioning

confidence: 99%

Ascorbate and Dehydroascorbic Acid as Reliable Biomarkers of Oxidative Stress: Analytical Reproducibility and Long-term Stability of Plasma Samples Subjected to Acidic Deproteinization

Lykkesfeldt

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Lack of post-sampling stability of ascorbate and dehydroascorbic acid and failure to block their in vivo equilibrium have lowered their value as biomarkers of oxidative stress and limited the ability to further investigate their possible role in disease prevention. In the present article, analytic reproducibility was tested by repeated analysis of plasma aliquots from one individual over 4 years. The plasma was subjected to acidic deproteinization with an equal volume of 10% meta-phosphoric acid containing 2 mmol/L of EDTA and analyzed for ascorbate and dehydroascorbic acid by high-performance liquid chromatography with coulometric detection. In a parallel experiment, the stability of human plasma samples treated as above and stored at À80°C for 5 years was tested in a cohort of 131 individuals. No degradation or shift in the equilibrium between ascorbate and dehydroascorbic acid was observed in either of the experiments. In conclusion, ascorbate and dehydroascorbic acid could be adequately preserved in plasma stored at À80°C following acidic deproteinization with meta-phosphoric acid containing 2 mmol/L of EDTA. (Cancer Epidemiol Biomarkers Prev 2007;16(11):2513-6)

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Section: Introductionmentioning

confidence: 99%

Ascorbate and Dehydroascorbic Acid as Reliable Biomarkers of Oxidative Stress: Analytical Reproducibility and Long-term Stability of Plasma Samples Subjected to Acidic Deproteinization

Lykkesfeldt

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…During cardiac surgery with extracorporeal circulation (ECC), a series of immunological and inflammatory alterations occur, which trigger oxidative stress 1,2 . Under the nonphysiological conditions during the ECC and due to the alterations related to ischemia-reperfusion, a large amount of free radicals is formed 3 .…”

Section: Introductionmentioning

confidence: 99%

Zinco em crianças submetidas à cirurgia cardíaca com circulação extracorpórea

Zanoni¹,

Melnikov²,

Consolo³

et al. 2008

Arq. Bras. Cardiol.

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“…4 It has also been demonstrated that ROS levels are elevated at the end of CPB and that these elevated levels precede the peak inflammatory response, (which occurs from 3hr post-CPB). 20 Elevated ROS are associated with a host of post-operative complications, including POAF, reduced pulmonary function, acute kidney injury (AKI) and neurological sequela. [21][22][23][24] During this period there are also concurrent reductions in selenium.…”

Section: Selenium Reductions In the Surgicalmentioning

confidence: 99%

“…Intra-operatively the important triggers to oxidative stress are myocardial ischemia-reperfusion, 141 inflammation, 20 hyperoxia, 142 PRBC transfusion 57 and blood contact with the CPB circuit. 47 Levels of lipid peroxidation and protein carbonyl products are elevated in the myocardium, especially after ischemic reperfusion at the end of surgery.…”

Section: Association Of Oxidative Stress and Selenium On Poafmentioning

confidence: 99%

“…31,45 Acute increases in oxidative stress are associated with increased morbidity (such as post-operative atrial fibrillation (POAF), acute kidney injury (AKI) and acute lung injury), 32,43,44 and mortality. However, while all patients exposed to CPB experience an inflammatory and oxidative stress response, 20,45,130 not all patients suffer the negative effects of these responses. However, rather than requesting costly blood tests for pre-operative oxidative stress levels (that may not get to be analysed prior to surgery), it would be beneficial to categorise patients into "at risk" groups pre-operatively.…”

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confidence: 99%

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Selenium and oxidative stress modulation during extracorporeal circulation

McDonald¹

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Oxidative stress occurs when there is an imbalance between reactive oxygen and nitrogen species (RNOS) and the antioxidant system. In cardiac surgery patients and the critically ill there is an association between oxidative stress and morbidity and mortality.Extracorporeal circulation (ECC) encompasses cardiopulmonary bypass (CPB) which is used for cardiac surgery; extracorporeal membrane oxygenation (ECMO) which is used for cardio-respiratory support in the critically ill and haemodialysis which is used in patients with intermittent or end-stage renal failure.During ECC, the patient's total blood volume is in direct contact with an artificial surface for extended periods. In addition, there is often pre-existing inflammation, surgical trauma and/or ischemia-reperfusion (I-R) injury, all of which are major activators for the increased production of RNOS. Concurrent decreases in the level of essential antioxidants and trace elements (such as selenium, zinc and copper) occur, which upset redox balance in favour of oxidative stress. The trace element selenium is required for the normal function of the antioxidant enzyme glutathione peroxidase (GPx). Despite in vitro and biochemical data suggesting that reinforcement of antioxidant activity by selenium supplementation might reduce excessive oxidative stress damage, there is conflicting evidence in clinical studies.The reason for failure of antioxidant supplementation in the clinical setting is currently unclear.We postulated that the ECC and its associated interventions such as transfusion, might have a larger impact on trace element loss, antioxidant function and the oxidative stress response than previously recognised. This led to the following questions:  What is the selenium level in healthy Queensland residents, and is this level similar to that reported in other parts of the world? Does a patient's pre-CPB or pre-ECMO circulating selenium level influence their outcome? Does the ECC independently alter circulating selenium levels and the oxidative stress response? Do other interventions during ECC, such as transfusion, alter circulating selenium and oxidative stress levels?iii This thesis focussed on oxidative stress and the trace element selenium, because oxidative stress is associated with poorer outcomes in cardiac and critically ill patients, and decreased selenium is independently associated with poorer outcomes. To answer the research questions outlined above, a series of experiments were designed and conducted, and they generated the following new information.The average selenium level in a Queensland blood donor population was defined at 1.09 µmol/L (Chapter 3). In addition 88.5% of participants had a selenium level lower than the critical level required for maximal glutathione peroxidase activity, which has previously been determined to be between 1.14 -1.27 µmol/L. Furthermore, this study generated novel information that packed red blood cells and buffy coat pooled platelets have very low levels of selenium (≤ 0.3 µmol/L).The effect of car...

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Oxidative stress precedes peak systemic inflammatory response in pediatric patients undergoing cardiopulmonary bypass operation

Cited by 92 publications

References 41 publications

Ascorbate and Dehydroascorbic Acid as Reliable Biomarkers of Oxidative Stress: Analytical Reproducibility and Long-term Stability of Plasma Samples Subjected to Acidic Deproteinization

Ascorbate and Dehydroascorbic Acid as Reliable Biomarkers of Oxidative Stress: Analytical Reproducibility and Long-term Stability of Plasma Samples Subjected to Acidic Deproteinization

Zinco em crianças submetidas à cirurgia cardíaca com circulação extracorpórea

Selenium and oxidative stress modulation during extracorporeal circulation

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