Mustafa AKAR, Gülden BAŞKOL, Mehmet YÜCESOY

Evaluation of oxidative stress in pregnants with chronic hepatitis B and C

Aim: This study was aimed to investigate the levels of antioxidant markers (paraoxonase, superoxide dismutase, glutathione peroxidase, and thiol) and oxidative stress markers (advanced oxidation protein products, xanthin oxidase, nitric oxide, malondialdehyde, and 8-hydroxydeoxyguanosine) in pregnant women with chronic hepatitis B and C. Material and Method: Sixty pregnant women in the last trimester, 20 of whom had chronic hepatitis B, another 20 of whom had chronic hepatitis C, and the remaining 20 of whom were healthy controls, were enrolled in this study. Demographic, clinical and laboratory data were recorded for all patients. Results: When compared to the healthy controls, the pregnant women with chronic hepatitis B and C displayed significantly lower levels of paraoxonase, glutathione peroxidase, and thiol (p<0.001). Superoxide dismutase levels were also lower in the chronic hepatitis B and C patients, in comparison to the healthy controls, yet this difference was statistically insignificant (p=0.76). Compared to the healthy controls, the chronic hepatitis B and C patients had significantly higher levels of advanced oxidation protein and xanthine oxidase (p<0.001). The nitric oxide levels of the chronic hepatitis B and C patients were significantly lower than those of the control group (p<0.05). No statistically significant difference was observed between the chronic hepatitis B and C patients and the controls for malondialdehyde and 8-hydroxydeoxyguanosine levels (p>0.05). Conclusion: Oxidative stress had significantly increased in pregnant women chronically infected with the hepatitis B and C viruses, when compared to healthy pregnant women. Thus, we suggest that pregnant women chronically infected with the hepatitis B and C viruses should be closely monitored throughout pregnancy for diseases induced by oxidant-antioxidant imbalance, such as preeclampsia, gestational diabetes and gestational hypertension.

Keywords:

Antioxidant activity, chronic hepatitis B chronic hepatitis C, oxidative stress, pregnancy,

PDF

___

1. Pardee M. Diagnosis and management of Hepatitis B and C. Nurs Clin North Am. 2019;54:277-84.
2. Hyun Kim B, Ray Kim W. Epidemiology of Hepatitis B Virus Infection in the United States. Clin Liver Dis (Hoboken). 2018;12:1-4.
3. World Health Organization. Global hepatitis report 2017 2017. Geneva. Licence: CC BY-NC-SA 3.0 IGO. Available at: http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/. Accessed October 23, 2018.
4. Sinclair AJ, Barnett AH, Lunec J. Free radicals and antioxidant systems in health and disease. Br J Hosp Med. 1990;43:334-44.
5. Şentürk H. Serbest radikal hasarının hepato-biliyer sistem hastalıklarındaki rolü. Kocatepe Tıp Derg 2004; 5: 1-8.
6. Bingöl S, Aydın S, Açıkgöz Ş. Free radicals. Medical Journal of Ankara Hospital. 1993; 28:2, Supp.1.
7. Mackness MI, Durrington PN, Ayub A, Mackness B. Low serum paraoxonase: a risk factor for atherosclerotic disease?. Chem Biol Interact. 1999;119-120:389-97.
8. Valko M, Rhodes CJ, Moncol J, Izakovic M, Mazur M. Free radicals, metals and antioxidants in oxidative stress-induced cancer. Chem Biol Interact. 2006;160:1-40.
9. Stehbens WE. Oxidative stress in viral hepatitis and AIDS. Experimental and Molecular Pathology, 2004; 77: 121-32.
10. Ames BN, Shigenaga MK, Hagen TM. Oxidants, antioxidants, and the degenerative diseases of aging. Proc Natl Acad Sci U S A. 1993;90:7915-22.
11. Memişoğulları R. Diyabettte serbest radikallerin rolü ve antioksidanların etkisi. Düzce Tıp Fakültesi Derg 2005; 3: 30-39.
12. Himmelfarb J, McMenamin E, McMonagle E. Plasma aminothiol oxidation in chronic hemodialysis patients. Kidney Int. 2002;61:705-16.
13. Witko-Sarsat V, Gausson V, Nguyen AT, et al. AOPP-induced activation of human neutrophil and monocyte oxidative metabolism: a potential target for N-acetylcysteine treatment in dialysis patients. Kidney Int. 2003;64:82-91.
14. Akyol O, Gökbulut I, Köksal N, Akin H, Ozyurt H, Yildirim Z. The activities of purine catabolizing enzymes in plasma and bronchial washing fluid in patients with lung cancer and pneumonia. Clin Biochem. 2001;34:251-54.
15. Irmak MK, Koltuksuz U, Kutlu NO, et al. The effect of caffeic acid phenethyl ester on ischemia-reperfusion injury in comparison with alpha-tocopherol in rat kidneys. Urol Res. 2001;29:190-93.
16. Cuzzocrea S, Riley DP, Caputi AP, Salvemini D. Antioxidant therapy: a new pharmacological approach in shock, inflammation, and ischemia/reperfusion injury. Pharmacol Rev. 2001;53:135-59.
17. Moro MA, Russel RJ, Cellek S, et al. cGMP mediates the vascular and platelet actions of nitric oxide: confirmation using an inhibitor of the soluble guanylyl cyclase. Proc Natl Acad Sci U S A. 1996;93:1480-85.
18. Kaçmaz B, Öğüş E, Paşaoğlu H, et al. Akut ve kronik viral hepatitli hastalarda lipid peroksidasyonu ve oksidasyona direncin incelenmesi. Viral Hepatit Dergisi 2001; 7: 374-78.
19. Shigenaga MK, Gimeno CJ, Ames BN. Urinary 8-hydroxy-2'-deoxyguanosine as a biological marker of in vivo oxidative DNA damage. Proc Natl Acad Sci U S A. 1989;86:9697-701.
20. Kasai H. Analysis of a form of oxidative DNA damage, 8-hydroxy-2'-deoxyguanosine, as a marker of cellular oxidative stress during carcinogenesis. Mutat Res. 1997;387:147-63.
21. Loguercio C, Federico A. Oxidative stress in viral and alcoholic hepatitis. Free Radic Biol Med. 2003;34:1-10.
22. Little RE, Gladen BC. Levels of lipid peroxides in uncomplicated pregnancy: a review of the literature. Reprod Toxicol. 1999;13:347-52.
23. Hubel CA, Roberts JM, Taylor RN, Musci TJ, Rogers GM, McLaughlin MK. Lipid peroxidation in pregnancy: new perspectives on preeclampsia. Am J Obstet Gynecol. 1989;161:1025-34.
24. Poranen AK, Ekblad U, Uotila P, Ahotupa M. Lipid peroxidation and antioxidants in normal and pre-eclamptic pregnancies. Placenta. 1996;17:401-05.
25. Cester N, Staffolani R, Rabini RA, et al. Pregnancy-induced hypertension: a role for peroxidation in microvillus plasma membranes. Mol Cell Biochem. 1994;131:151-5.
26. Aslan M, Horoz M, Nazligul Y, et al. Serum paraoxonase and arylesterase activities for the evaluation of patients with chronic hepatitis. Int J Clin Pract. 2008;62:1050-5.
27. Ferré N, Camps J, Prats E, et al. Serum paraoxonase activity: a new additional test for the improved evaluation of chronic liver damage. Clin Chem. 2002;48:261-8.
28. Kilic SS, Aydin S, Kilic N, Erman F, Aydin S, Celik I. Serum arylesterase and paraoxonase activity in patients with chronic hepatitis. World J Gastroenterol. 2005;11:7351-4.
29. Ferré N, Marsillach J, Camps J, et al. Paraoxonase-1 is associated with oxidative stress, fibrosis and FAS expression in chronic liver diseases. J Hepatol. 2006;45:51-59.
30. Kumru S, Aydin S, Gursu MF, Ozcan Z. Changes of serum paraoxonase (an HDL-cholesterol-associated lipophilic antioxidant) and arylesterase activities in severe preeclamptic women. Eur J Obstet Gynecol Reprod Biol. 2004;114(2):177-81.
31. Kaya S, Sütçü R, Çetin ES, et al. Relationship Between Viral Load and Lipid Peroxidation and Antioxidant Enzymes in Patients Infected with Hepatitis B Virus. Türk Klinik Biyokimya Derg 2006; 4: 77-82.
32. Levent G, Ali A, Ahmet A, et al. Oxidative stress and antioxidant defense in patients with chronic hepatitis C patients before and after pegylated interferon alfa-2b plus ribavirin therapy. J Transl Med. 2006;4:25. Published 2006 Jun 20.
33. Yesilova Z, Yaman H, Oktenli C, et al. Systemic markers of lipid peroxidation and antioxidants in patients with non-alcoholic fatty liver disease. Am J Gastroenterol. 2005;100:850-55.
34. Chrobot AM, Szaflarska-Szczepanik A, Drewa G. Antioxidant defense in children with chronic viral hepatitis B and C. Med Sci Monit. 2000;6:713-18.
35. Karabulut AB, Sömmez E, Bayindir Y, Gözükara E. A comparison of erythrocyte superoxide dismutase and catalase activity in patients with hepatitis C infection. Turkish Journal of Medical Sciences. 2002; 32: 313–6.
36. Baskol G, Baskol M, Kocer D. Oxidative stress and antioxidant defenses in serum of patients with non-alcoholic steatohepatitis. Clin Biochem. 2007;40:776-80.
37. Boya P, de la Peña A, Beloqui O, et al. Antioxidant status and glutathione metabolism in peripheral blood mononuclear cells from patients with chronic hepatitis C. J Hepatol. 1999;31:808-14.
38. Ko WS, Guo CH, Yeh MS, et al. Blood micronutrient, oxidative stress, and viral load in patients with chronic hepatitis C. World J Gastroenterol. 2005;11:4697-4702.
39. Czuczejko J, Zachara BA, Staubach-Topczewska E, Halota W, Kedziora J. Selenium, glutathione and glutathione peroxidases in blood of patients with chronic liver diseases. Acta Biochim Pol. 2003;50:1147-54.
40. Romero FJ, Bosch-Morell F, Romero MJ, et al. Lipid peroxidation products and antioxidants in human disease. Environ Health Perspect. 1998; 106 Suppl 5 (Suppl 5):1229-34.
41. Zuwała-Jagiełło J, Pazgan-Simon M, Simon K, Warwas M. Elevated advanced oxidation protein products levels in patients with liver cirrhosis. Acta Biochim Pol. 2009;56:679-85.
42. Llurba E, Gratacós E, Martín-Gallán P, Cabero L, Dominguez C. A comprehensive study of oxidative stress and antioxidant status in preeclampsia and normal pregnancy. Free Radic Biol Med. 2004;37:557-70.
43. Sögüt S, Aydin E, Elyas H, et al. The activities of serum adenosine deaminase and xanthine oxidase enzymes in Behcet's disease. Clin Chim Acta. 2002;325:133-38.
44. Ou SY, Jackson GM, Jiao X, Chen J, Wu JZ, Huang XS. Protection against oxidative stress in diabetic rats by wheat bran feruloyl oligosaccharides. J Agric Food Chem. 2007;55:3191-95.
45. Baldus S, Köster R, Chumley P, et al. Oxypurinol improves coronary and peripheral endothelial function in patients with coronary artery disease. Free Radic Biol Med. 2005;39:1184-90.
46. Battelli MG, Musiani S, Valgimigli M, et al. Serum xanthine oxidase in human liver disease. Am J Gastroenterol. 2001;96:1194-9.
47. El-Sherif AM, Abou-Shady MA, Al-Bahrawy AM, Bakr RM, Hosny AM. Nitric oxide levels in chronic liver disease patients with and without oesophageal varices [published correction appears in Hepatol Int. 2008;2:395-6]. Hepatol Int. 2008;2:341-45.
48. Yadav D, Hertan HI, Schweitzer P, Norkus EP, Pitchumoni CS. Serum and liver micronutrient antioxidants and serum oxidative stress in patients with chronic hepatitis C. Am J Gastroenterol. 2002;97:2634-39.
49. Fujita N, Sugimoto R, Ma N, et al. Comparison of hepatic oxidative DNA damage in patients with chronic hepatitis B and C. J Viral Hepat. 2008;15:498-07.
50. Kitada T, Seki S, Iwai S, Yamada T, Sakaguchi H, Wakasa K. In situ detection of oxidative DNA damage, 8-hydroxydeoxyguanosine, in chronic human liver disease. J Hepatol. 2001;35:613-8.