Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Investigation of the Oxidative Process by Measuring Total Antioxidant Capacity and Total Oxidant Capacity in Patients with Mucopolysaccharidosis: Cross-Sectional Prospective Study
Mukopolisakkaridoz Hastalarında Total Antioksidan Kapasite ve Total Oksidan Kapasite Ölçümleri Yapılarak Oksidatif Sürecin Araştırılması: Kesitsel Prospektif Çalışma
Eylem Şerife KALKANa , Aynur KÜÇÜKÇONGAR YAVAŞb , Özlem ÜNAL UZUNc , Mehmet GÜNDÜZb
a Ankara City Hospital, Clinic of Pediatrics, Ankara, Türkiye
bAnkara City Hospital, Clinic of Pediatric Metabolism, Ankara, Türkiye
cKocaeli University Faculty of Medicine, Department of Pediatric Metabolism, Kocaeli, Türkiye
Turkiye Klinikleri J Pediatr. 2024;33(1):1-7
doi: 10.5336/pediatr.2023-98909
Article Language: EN
Full Text
ABSTRACT
Objective: To compare the oxidative stress status between the patients with mucopolysaccharidosis who received and did not receive enzyme replacement therapy and healthy control group. Material and Methods: A retrospective study of mucopolysaccharidosis patients with analysis of the total oxidant and antioxidant capacity levels. Results: We included 29 mucopolysaccharidosis patients aged between 1-18 years and 50 healthy children. Total antioxidant capacity and total oxidant capacity parameters between this patients and healthy control group were compared. The median age of the patients who were included in the study was 9.0 years and the median age of the cases included in the control group was 8.0 years. Total antioxidant capacity, total oxidant capacity and Oxidative Stress Index (OSI) values did not differ significantly in patients receiving enzyme replacement therapy compared to patients who did not receive enzyme replacement therapy. A comparison of the oxidant and antioxidant system parameters between the patient and control groups revealed a distinct difference, with the control group exhibiting a considerably higher total antioxidant capacity than mucopolysaccharidosis patients, and the patient group showing a significantly higher total oxidant capacity and OSI. Conclusion: In this study, it was observed that the antioxidant defence system decreased in patients with mucopolysaccharidoses. It is thought that, in addition to standard treatments, the administration of antioxidant treatments and supporting nutrition in mucopolysaccharidosis patients will increase the quality of life of the patients. Regular sleep, eating healthy foods and doing regular exercise would also increase the effectiveness of these supplements.

Keywords: Mucopolysaccharidoses; oxidative stress; oxidants; antioxidants
ÖZET
Amaç: Bu çalışmanın amacı, enzim replasman tedavisi alan ve almayan mukopolisakkaridozlu hastalar ile sağlıklı kontrol grubu arasındaki oksidatif stres durumunu karşılaştırmaktır. Gereç ve Yöntemler: Total oksidan kapasite ve total antioksidan kapasite düzeylerinin analizi ile mukopolisakkaridoz hastalarının oksidatif stres seviyelerinin retrospektif incelenmesi. Bulgular: Çalışmaya 1-18 yaş arası 29 mukopolisakkaridoz hastası ve aynı yaş grubunda 50 sağlıklı çocuk dâhil edildi. Bu hastalar ile sağlıklı kontrol grubu arasındaki toplam antioksidan kapasite ve toplam oksidan kapasite parametreleri karşılaştırıldı. Çalışmaya alınan hastaların yaş ortalaması 9,0 iken, kontrol grubuna alınan olguların yaş ortalaması 8,0 yaş idi. Enzim replasman tedavisi alan hastalarda total antioksidan kapasite, total oksidan kapasite ve Oksidatif Stres İndeksi (OSİ) değerleri, enzim replasman tedavisi almayan hastalara göre anlamlı farklılık göstermedi. Hasta grubu ve kontrol grubu değerleri oksidan ve antioksidan sistem parametreleri açısından karşılaştırıldığında, kontrol grubunun total antioksidan kapasite değeri mukopolisakkaridoz hastalarına göre anlamlı olarak yüksek olmasına rağmen total oksidan kapasite ve OSİ değerleri hasta grubunda anlamlı olarak yüksek bulundu. Sonuç: Bu çalışmada, mukopolisakkaridozlu hastalarda antioksidan savunma sisteminin azaldığı gözlendi. Mukopolisakkaridoz hastalarında standart tedavilere ek olarak antioksidan tedaviler ve beslenmeyi destekleyici uygulamaları hastaların yaşam kalitelerini artırabilir. Düzenli uyku, sağlıklı besinler yemek ve düzenli egzersiz yapmak da bu takviyelerin etkinliğini artırabilir.

Anahtar Kelimeler: Mukopolisakkaridozlar; oksidatif stres; oksidanlar; antioksidanlar
REFERENCES:
  1. Muenzer J. Overview of the mucopolysaccharidoses. Rheumatology (Oxford). 2011;50 Suppl 5:v4-12. [Crossref]  [PubMed] 
  2. Baehner F, Schmiedeskamp C, Krummenauer F, Miebach E, Bajbouj M, Whybra C, et al. Cumulative incidence rates of the mucopolysaccharidoses in Germany. J Inherit Metab Dis. 2005;28(6):1011-7. [Crossref]  [PubMed] 
  3. Wraith JE. The mucopolysaccharidoses: a clinical review and guide to management. Arch Dis Child. 1995;72(3):263-7. [Crossref]  [PubMed]  [PMC] 
  4. Scriver CR, Beaudet AL, Sly WS, Valle D. The Metabolic and Molecular Bases of Inherited Disease. 7th ed. Vol. 3. New York: McGraw Hill; 1995. [Link] 
  5. Gallegos-Arreola MP, Machorro-Lazo MV, Flores-Martínez SE, Zúñiga-González GM, Figuera LE, González-Noriega A, et al. Urinary glycosaminoglycan excretion in healthy subjects and in patients with mucopolysaccharidoses. Arch Med Res. 2000;31(5):505-10. [Crossref]  [PubMed] 
  6. Hampe CS, Eisengart JB, Lund TC, Orchard PJ, Swietlicka M, Wesley J, et al. Mucopolysaccharidosis Type I: A Review of the Natural History and Molecular Pathology. Cells. 2020;9(8):1838. [Crossref]  [PubMed]  [PMC] 
  7. Schlesier K, Harwat M, Böhm V, Bitsch R. Assessment of antioxidant activity by using different in vitro methods. Free Radic Res. 2002;36(2):177-87. [Crossref]  [PubMed] 
  8. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38(12):1103-11. [Crossref]  [PubMed] 
  9. Donida B, Marchetti DP, Biancini GB, Deon M, Manini PR, da Rosa HT, et al. Oxidative stress and inflammation in mucopolysaccharidosis type IVA patients treated with enzyme replacement therapy. Biochim Biophys Acta. 2015;1852(5):1012-9. [Crossref]  [PubMed] 
  10. Johnson GB, Brunn GJ, Kodaira Y, Platt JL. Receptor-mediated monitoring of tissue well-being via detection of soluble heparan sulfate by Toll-like receptor 4. J Immunol. 2002;168(10):5233-9. [Crossref]  [PubMed] 
  11. Donida B, Marchetti DP, Jacques CED, Ribas G, Deon M, Manini P, et al. Oxidative profile exhibited by Mucopolysaccharidosis type IVA patients at diagnosis: Increased keratan urinary levels. Mol Genet Metab Rep. 2017;11:46-53. [Crossref]  [PubMed]  [PMC] 
  12. Villani GR, Di Domenico C, Musella A, Cecere F, Di Napoli D, Di Natale P. Mucopolysaccharidosis IIIB: oxidative damage and cytotoxic cell involvement in the neuronal pathogenesis. Brain Res. 2009;1279:99-108. [Crossref]  [PubMed] 
  13. Hamano K, Hayashi M, Shioda K, Fukatsu R, Mizutani S. Mechanisms of neurodegeneration in mucopolysaccharidoses II and IIIB: analysis of human brain tissue. Acta Neuropathol. 2008;115(5):547-59. [Crossref]  [PubMed] 
  14. Simonaro CM, Haskins ME, Schuchman EH. Articular chondrocytes from animals with a dermatan sulfate storage disease undergo a high rate of apoptosis and release nitric oxide and inflammatory cytokines: a possible mechanism underlying degenerative joint disease in the mucopolysaccharidoses. Lab Invest. 2001;81(9):1319-28. [Crossref]  [PubMed] 
  15. Simonaro CM, D'Angelo M, He X, Eliyahu E, Shtraizent N, Haskins ME, et al. Mechanism of glycosaminoglycan-mediated bone and joint disease: implications for the mucopolysaccharidoses and other connective tissue diseases. Am J Pathol. 2008;172(1):112-22. [Crossref]  [PubMed]  [PMC] 
  16. Filippon L, Vanzin CS, Biancini GB, Pereira IN, Manfredini V, Sitta A, et al. Oxidative stress in patients with mucopolysaccharidosis type II before and during enzyme replacement therapy. Mol Genet Metab. 2011;103(2):121-7. [Crossref]  [PubMed] 
  17. Roversi FM, Galdieri LC, Grego BH, Souza FG, Micheletti C, Martins AM, et al. Blood oxidative stress markers in Gaucher disease patients. Clin Chim Acta. 2006;364(1-2):316-20. [Crossref]  [PubMed] 
  18. Aguilar Delgado C, Hammerschmidt T, Faverzini JL, Lopes F, Giugliani R, Baldo G, et al. Inflammatory process and oxidative/nitrative stress: in vivo study in mucopolysaccharidosis type IV A patients under long-term enzyme replacement therapy. Arch Biochem Biophys. 2023;737:109541. [Crossref]  [PubMed] 
  19. Oliveira-Silva JA, Yamamoto JUP, Oliveira RB, Monteiro VCL, Frangipani BJ, Kyosen SO, et al. Oxidative stress assessment by glutathione peroxidase activity and glutathione levels in response to selenium supplementation in patients with Mucopolysaccharidosis I, II and VI. Genet Mol Biol. 2019;42(1):1-8. [Crossref]  [PubMed]  [PMC] 
  20. Matalonga L, Arias A, Coll MJ, Garcia-Villoria J, Gort L, Ribes A. Treatment effect of coenzyme Q(10) and an antioxidant cocktail in fibroblasts of patients with Sanfilippo disease. J Inherit Metab Dis. 2014;37(3):439-46. [Crossref]  [PubMed] 
  21. Moskot M, Gabig-Cimińska M, Jakóbkiewicz-Banecka J, Węsierska M, Bocheńska K, Węgrzyn G. Cell cycle is disturbed in mucopolysaccharidosis type II fibroblasts, and can be improved by genistein. Gene. 2016;585(1):100-3. [Crossref]  [PubMed] 
  22. Delgado CA, Poletto E, Vera LNP, Jacques CED, Vianna P, Reinhardt LS, et al. Effect of genistein and coenzyme Q10 in oxidative damage and mitochondrial membrane potential in an attenuated type II mucopolysaccharidosis cellular model. Cell Biochem Funct. 2024;42(2):e3932. [Crossref]  [PubMed] 
  23. Jacques CED, Lopes FF, Poletto E, Vera LNP, Vianna P, Reinhardt LS, et al. Evaluation of oxidative stress and mitochondrial function in a type II mucopolysaccharidosis cellular model: in vitro effects of genistein and coenzyme Q10. Metab Brain Dis. 2023;38(2):519-29. [Crossref]  [PubMed] 

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