Recep SÜTÇÜ, Hicran HİÇYILMAZ, Münire GÖKIRMAK, Önder ÖZTÜRK, Ahmet AKKAYA, Ahmet BİRCAN

Total Antioxidant Capacity and C-Reactive Protein Levels in Patients with Community-Acquired Pneumonia

Aims: The aim of this study was to evaluate the oxidative stress measured by serum total antioxidant capacity (TAC) and malondialdehyde (MDA) in patients with community-acquired pneumonia (CAP), and to evaluate their possible correlation with the serum C-reactive protein (CRP) and pneumonia severity index (PSI). Materials and Methods: The PSI, chest X-ray (CXR) scores, and the serum TAC, MDA, and CRP levels were determined in 67 CAP patients on admission and compared to 45 healthy controls. Results: In the whole study population, the TAC level was inversely correlated with CRP levels and WBC counts (r=-0.648, P=0.0001; r=-0.626, P=0.0001, respectively). Lower TAC and higher MDA levels were found in CAP patients compared with those of controls (P = 0.0001, P = 0.029). Although the mean serum MDA and TAC levels were similar between the groups of PSI class I-III (n=45) and PSI class IV-V (n=22), the radiological scores (2.36±1.23 vs 3.19±1.17) and CRP levels (138.67 ± 63.86 vs 177.14 ± 56.43) were significantly higher in the latter group (P = 0.010 and P=0.005, respectively). Conclusions: Single measurement of serum MDA or TAC levels in CAP patients, in contrast to CRP level measurement, does not seem to predict the severity of disease.

Anahtar Kelimeler:

Community-acquired pneumonia, C-reactive protein, malondialdehyde, oxidative stress, pneumonia severity index, total antioxidant capacity

Total Antioxidant Capacity and C-Reactive Protein Levels in Patients with Community-Acquired Pneumonia

Keywords:

Community-acquired pneumonia, C-reactive protein, malondialdehyde, oxidative stress, pneumonia severity index, total antioxidant capacity,

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Repine JE, Bast A, Lankhorst I. Oxidative stress in chronic obstructive pulmonary disease. Oxidative Stress Study Group. Am J Respir Crit Care Med 1997; 156: 341-57.
Rahman I, Adcock IM. Oxidative stress and redox regulation of lung inflammation in COPD. Eur Respir J 2006; 28: 219-42.
Caramori G, Papi A. Oxidants and asthma. Thorax 2004; 59: 170-3.
Horvath I, Loukides S, Wodehouse T, Kharitonov SA, Cole PJ, Barnes PJ. Increased levels of exhaled carbon monoxide in bronchiectasis: a new marker of oxidative stress. Thorax 1998; 53: 867-70.
Rahman I, Morrison D, Donaldson K, MacNee W. Systemic oxidative stress in asthma, COPD, and smokers. Am J Respir Crit Care Med 1996; 154: 1055-60. 6. Wood LG, Garg ML, Simpson JL, Mori TA, Croft KD, Wark PA et al. Induced sputum 8-isoprostane concentrations in inflammatory airway diseases. Am J Respir Crit Care Med 2005; 171: 426-30.
Lenz AG, Costabel U, Maier KL. Oxidized BAL fluid proteins in patients with interstitial lung diseases. Eur Respir J 1996; 9: 307-12. 8. Kostikas K, Papatheodorou G, Psathakis K, Panagou P, Loukides S. Oxidative stress in expired breath condensate of patients with COPD. Chest 2003; 124: 1373-80. 9. Katsoulis K, Kontakiotis T, Baltopoulos G, Kotsovili A, Legakis IN. Total antioxidant status and severity of community-acquired pneumonia: are they correlated? Respiration 2005; 72: 381-7.
Welte T, Suttorp N, Marre R. CAPNETZ-community-acquired pneumonia competence network. Infection 2004; 32: 234-8.
Almirall J, Bolibar I, Vidal J, Sauca G, Coll P, Niklasson B et al. Epidemiology of community-acquired pneumonia in adults: a population-based study. Eur Respir J 2000; 15: 757-63.
Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997; 336: 243- 50.
Ewig S, Torres A, Woodhead M. Assessment of pneumonia severity: a European perspective. Eur Respir J 2006; 27: 6-8.
Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD et al. American Thoracic Society. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001; 163: 1730-54.
British Thoracic Society Standards of Care Committee. BTS guidelines for the management of community-acquired pneumonia in adults. Thorax 2001; 56 (Suppl 4): IV1-64.
Toraks Derneği. [Erişkinlerde toplum kökenli pnömoni tanı ve tedavi rehberi.] Toraks Dergisi 2002; 3 (Ek 3): 1-15.
Almirall J, Bolibar I, Toran P, Pera G, Boquet X, Balanzo X et al.; Community-Acquired Pneumonia Maresme Study Group. Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest 2004; 125: 1335-42.
Cemek M, Caksen H, Bayiroğlu F, Cemek F, Dede S. Oxidative stress and enzymic-non-enzymic antioxidant responses in children with acute pneumonia. Cell Biochem Funct 2006; 24: 269-73.
Laskaj R, Slavica D, Cepelak I, Kuzman I. Gamma- glutamyltransferase activity and total antioxidant status in serum and platelets of patients with community-acquired pneumonia. Arch Med Res 2007; 38: 424-31.
Duflo F, Debon R, Goudable J, Chassard D, Allaouchiche B. Alveolar and serum oxidative stress in ventilator-associated pneumonia. Br J Anaesth 2002; 89: 231-6.
Majewska E, Kasielski M, Luczynski R, Bartosz G, Bialasiewicz P, Nowak D. Elevated exhalation of hydrogen peroxide and thiobarbituric acid reactive substances in patients with community acquired pneumonia. Respir Med 2004; 98: 669-76.
Nowak D, Zieba M, Zawiasa D, Rozniecki J, Król M. Changes of serum concentration of lipid peroxidation products in patients with pneumonia. Monaldi Arch Chest Dis 1996; 51: 188-93.
Li GF, He YF, Huang MR, Guo JL, Wu QT, Chen SJ. [Determination of serum superoxide dismutase, glutathione peroxidase, total antioxidative capacity, malondialdehyde in patients with pneumonia]. Di Yi Jun Yi Da Xue Xue Bao 2003; 23: 961-2 (abstract).
Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem 2004; 37: 277-85.
Draper HH, Hadley M. Malondialdehyde determination as index of lipid peroxidation. Methods Enzymol 1990; 186: 421-31.
Umeki S, Sumi M, Niki Y, Soejima R. Concentrations of superoxide dismutase and superoxide anion in blood of patients with respiratory infections and compromised immune systems. Clin Chem 1987; 33: 2230-3.
Braun J, Pein M, Djonlagic H, Dalhoff K. Production of reactive oxygen species by central venous and arterial neutrophils in severe pneumonia and cardiac lung edema. Intensive Care Med 1997; 23: 170-6.
Stolarek RA, Kasielski M, Rysz J, Bialasiewicz P, Nowak D. Differential effect of cigarette smoking on hydrogen peroxide and thiobarbituric acid reactive substances exhaled in patients with community acquired pneumonia. Monaldi Arch Chest Dis 2006; 65: 19-25.
Abou-Seif MA. Blood antioxidant status and urine sulfate and thiocyanate levels in smokers. J Biochem Toxicol 1996; 11: 133- 8.
Samouilidou E, Grapsa E, Karpouza A, Lagouranis A. Reactive oxygen metabolites: a link between oxidative stress and inflammation in patients on hemodialysis. Blood Purif 2007; 25: 175-8.