Prognostic Value of Oxidative Stress Markers in Patients with Pulmonary Arterial or Chronic Thromboembolic Pulmonary Hypertension

Abstract

Oxidative stress is regarded to play a crucial role in the pathophysiology of pulmonary arterial hypertension (PAH) and inoperable chronic thromboembolic pulmonary hypertension (CTEPH). This study evaluated the prognostic value of serum oxidative stress markers (malondialdehyde (MDA), total antioxidant capacity (TAC), catalase activity (CAT), and superoxide activity (SOD)) in patients with PAH and CTEPH (n=45). During 13 months of follow-up (median 9 months), clinical deterioration occurred in 14 patients (including 2 deaths). On the Cox regression analysis, MDA, TAC, and CAT were associated with clinical deterioration (p=0.0068, HR=1.42, 95% CI: 1.10-1.82; p=0.0038, HR=0.033, 95% CI: 0.0032-0.33; and p=0.046, HR=0.20, 95% CI: 0.04-0.98, respectively). There was no significant difference in SOD (p=0.53, HR=0.97, 95% CI: 0.87-1.08). The cut-off value derived from ROC curve analysis was 3.79 μM (p=0.0048, AUC=0.76, 95% CI: 0.62-0.91) for MDA, 0.49 mM (p=0.027, AUC=0.71, 95% CI: 0.18-0.47) for TAC, and 1.34 U/L (p=0.029, AUC=0.71, 95% CI: 0.55-0.86) for CAT. MDA in the group with deterioration was higher (p=0.0041), while TAC as well as CAT were lower (p=0.027 and p=0.028, respectively) when compared to stable patients. Survival without clinical deterioration was significantly longer in patients with lower MDA (p=0.037, HR=0.37, 95% CI: 0.12-1.14, log-rank), higher TAC (p=0.0018, HR=0.19, 95% CI: 0.06-0.60, log-rank), and higher CAT (p=0.044, HR=0.31 95% CI: 0.11-0.88, log-rank). Markers of oxidative stress such as MDA, TAC, and CAT were associated with adverse clinical outcomes in patients with PAH and inoperable or residual CTEPH.

The effect of nigella sativa on biomarkers of inflammation and oxidative stress: A systematic review and meta‐analysis of randomized controlled trials

“…The current metaanalysis, conducted on 10 RCTs, showed that the administration of NS seed and seed oil significantly reduced serum hs-CRP, TNFα, and MDA levels, and significantly increased SOD and TAC levels. All of these molecules are widely used to assess the redox balance in different conditions (Smukowska-Gorynia et al, 2019). Our findings provide more underpinnings for the results of other studies that encompassed the impact of NS supplementation on traditional cardiometabolic markers (Daryabeygi-Khotbehsara et al, 2017;Sahebkar et al, 2016).…”

Hydrogen sulphide ameliorating skeletal muscle atrophy in db/db mice via Muscle RING finger 1 S‐sulfhydration

“…3,21 Thus, it is essential Mounting evidence has illustrated that oxidative stress plays a crucial role in the onset of diabetes and the development of its complications in various animal models. 22 Overexcessive ROS accumulation may enhance the aggregation of misfolding proteins in the ER, which is called as ER stress. Therefore, ER stress is inferred by activation of the unfolded protein response (UPR).…”

Vasoconstrictor Mechanisms in Chronic Hypoxia-Induced Pulmonary Hypertension: Role of Oxidant Signaling

“…It is likely that oxidative signaling is also involved in human PH/PAH as oxidative stress is increased in chronic high-altitude residents [ 302 ] and in PH patients [ 303 ]. Moreover, in PAH patients, oxidative stress markers correlate with an adverse prognosis [ 304 ], and reducing oxidative stress by epoprostenol [ 305 ] or by recombinant human angiotensin converting enzyme type 2 (rhACE2) [ 306 ] is associated with decreases in PVR in small scale clinical trials. Aside from PVR, preserving or improving right heart function is a crucial goal for disease management [ 307 ] because cor pulmonale occurring during PH is fatal.…”