Dynamics of indicators of oxidant-antioxidant reactions in the postoperative period in patients with disseminated peritonitis
DOI:
https://doi.org/10.15574/PS.2024.82.18Keywords:
peritonitis, abdominal sepsis, endogenous intoxication, multiorgan failure, oxidant-antioxidant reactionsAbstract
Purpose - to determine the effect of the developed treatment of patients with peritonitis on the dynamics of indicators of oxidant-antioxidant reactions and to justify the need for the use of the proposed drugs in the complex treatment of peritonitis.
Matherials and methods. The study included 124 patients with toxic and terminal stages of peritonitis, who were divided into 3 groups: the Group I included 39 patients in whose complex treatment we included cytochrome C; the Group II included 41 patients whose complex treatment included cytochrome C and a solution containing levocarnitine and arginine hydrochloride; the Comparison group included 44 patients in whom the specified drugs were not used. The content of diene conjugates, reactive oxygen species (ROS), S-nitrosothiols, superoxide dismutase (SOD), carbonyl groups, and sodium nitrite was determined in the patients. Statistical processing of the study results was performed using the Statistical software EZR v. 1.64.
Results. In patients of the Group I and the Group II, the use of the proposed treatment contributed to the optimization of oxidant-antioxidant reactions: a decrease in the production of diene conjugates, ROS, S-nitrosothiols, carbonyl groups, sodium nitrite during the study, optimization of SOD production, especially in the Group II. In patients of the Comparison group, decompensation in oxidant-antioxidant reactions was determined, associated with a significant increase in the production of diene conjugates, ROS, S-nitrosothiols and a decrease in SOD during the entire period. These trends developed against the background of an increase in the content of nitric oxide products and the activation of processes associated with the oxidative modification of blood plasma proteins.
Conclusions. The use of cytochrome C and a solution containing levocarnitine and arginine hydrochloride in the complex treatment of patients with disseminated peritonitis helps to optimize oxidant-antioxidant reactions, which leads to a decrease in the manifestations of inflammation.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Butler MJ, Down СJ, Foster RR, Satchell SC. (2020). The Pathological Relevance of Increased Endothelial Glycocalyx Permeability. Am J Pathol. 190(4): 742-751. https://doi.org/10.1016/j.ajpath.2019.11.015; PMid:32035881 PMCid:PMC7163249
Canton M, Sánchez-Rodríguez R, Spera I, Venegas FC, Favia M, Viola A et al. (2021). Reactive Oxygen Species in Macrophages: Sources and Targets. Front Immunol. 12: 734229. https://doi.org/10.3389/fimmu.2021.734229; PMid:34659222 PMCid:PMC8515906
Clements TW, Tolonen M, Ball CG, Kirkpatrick AW. (2021). Secondary peritonitis and intra-abdominal sepsis: an increasingly global disease in search of better systemic therapies. Scand J Surg. 110(2): 139-149. https://doi.org/10.1177/1457496920984078; PMid:33406974
De Pascale G, Antonelli M, Deschepper M, Arvaniti K, Blot K, Brown BC et al. (2022). Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis. Intensive Care Med. 48(11): 1593-1606. https://doi.org/10.1007/s00134-022-06883-y; PMid:36151335
Jobgen WS, Fried SK, Fu WJ, Meininger CJ, Wu G. (2006). Regulatory role for the arginine-nitric oxide pathway in metabolism of energy substrates. J Nutr Biochem. 17(9): 571-588. https://doi.org/10.1016/j.jnutbio.2005.12.001; PMid:16524713
Joffre J, Hellman J. (2021). Oxidative Stress and Endothelial Dysfunction in Sepsis and Acute Inflammation. Antioxid Redox Signal. 35(15): 1291-1307. https://doi.org/10.1089/ars.2021.0027; PMid:33637016
Jones DP. (2008). Radical-free biology of oxidative stress. American Journal of Physiology. Cellular Physiology. Am J Physiol Cell Physiol. 295(4): C849-868. https://doi.org/10.1152/ajpcell.00283.2008; PMid:18684987 PMCid:PMC2575825
Kalpage HA, Bazylianska V, Recanati MA, Fite A, Liu J, Wan J et al. (2019). Tissue-specific regulation of cytochrome c by post-translational modifications: respiration, the mitochondrial membrane potential, ROS, and apoptosis. FASEB J. 33(2): 1540-1553. https://doi.org/10.1096/fj.201801417R; PMid:30222078 PMCid:PMC6338631
Karol IV, Bilyayeva OO. (2023). Risk factors for severe peritonitis in surgical patients. Medical science of Ukraine. 19(3): 47-54. https://doi.org/10.32345/2664-4738.3.2023.07
Kumar S, Gupta E, Kaushik S, Kumar Srivastava V, Mehta SK, Jyoti A. (2018). Evaluation of oxidative stress and antioxidant status: Correlation with the severity of sepsis. Scand J Immunol. 87(4): e12653. https://doi.org/10.1111/sji.12653; PMid:29484685
Meo SD, Reed TT, Venditti P, Victor VM. (2016). Role of ROS and RNS sources in physiological and pathological conditions. Oxid Med Cell Longev. 2016: 1245049. https://doi.org/10.1155/2016/1245049; PMid:27478531 PMCid:PMC4960346
Montravers P, Assadi M, Gouel-Cheron A. (2021). Priorities in peritonitis. Curr Opin Crit Care. 27(2): 201-207. https://doi.org/10.1097/MCC.0000000000000805; PMid:33395082
Moreira E, Burghi G, Manzanares W. (2018). Update on metabolism and nutrition therapy in critically ill burn patients. Med Intensiva (Engl Ed). 42(5): 306-316. https://doi.org/10.1016/j.medin.2017.07.007; PMid:28951113
Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C et al. (2012). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 Regions, 1990-2010: A systematic analysis for the global burden of disease study 2010. Lancet. 380(9859): 2197-2223. https://doi.org/10.1016/S0140-6736(12)61689-4; PMid:23245608
Mutvedu VB, Nyongesa AW, Oduma JA, Kitaa JM, Mbariya JM. (2021). Thermal stress causes oxidative stress and physiological changes in female rabbits. J Therm Biol. 95: 102780. https://doi.org/10.1016/j.jtherbio.2020.102780; PMid:33454048
Napolitano LM. (2022). Intra-abdominal Infections. Semin Respir Crit Care Med. 43(1): 10-27. https://doi.org/10.1055/s-0041-1741053; PMid:35172355
Ramirez-Zuniga I, Rubin JE, Swigon D, Redl H, Clermont G. (2022). A data-driven model of the role of energy in sepsis. J Theor Biol. 533: 110948. https://doi.org/10.1016/j.jtbi.2021.110948; PMid:34757193
Rashid JS, Kumar SS, Job KM, Liu X, Fike CD, Sherwin CMT. (2020). Therapeutic potential of citrulline as an arginine supplement: a clinical pharmacology review. Paediatr Drugs. 22(3):279-293. https://doi.org/10.1007/s40272-020-00384-5; PMid:32140997 PMCid:PMC7274894
Roshangar L, Soleimani Rad J, Kheirjou R, Ranjkesh MR, Khosroshahi AF. (2019). Skin burns: review of molecular mechanisms and therapeutic approaches. Wounds. 31(12): 308-315.
Roumeliotis S, Dounousi E, Salmas M, Eleftheriadis T, Liakopoulos V. (2020). Unfavorable Effects of Peritoneal Dialysis Solutions on the Peritoneal Membrane: The Role of Oxidative Stress. Biomolecules. 10(5): 768. https://doi.org/10.3390/biom10050768; PMid:32423139 PMCid:PMC7277773
Takashima H, Maruyama T, Abe M. (2021). Significance of levocarnitine treatment in dialysis patients. Nutrients. 13(4): 1219. https://doi.org/10.3390/nu13041219; PMid:33917145 PMCid:PMC8067828
Wu Y, Li D, Wang H, Wan X. (2022). Protective Effect of Poria Cocos Polysaccharides on Fecal Peritonitis-Induced Sepsis in Mice Through Inhibition of Oxidative Stress, Inflammation, Apoptosis, and Reduction of Treg Cells. Front Microbiol. 13: 887949. https://doi.org/10.3389/fmicb.2022.887949; PMid:35694296 PMCid:PMC9184799
Zhou Y, Yang T, Namivandi-Zangeneh R, Boyer C, Liang K, Chandrawati R. (2021). Copper-doped metal-organic frameworks for the controlled generation of nitric oxide from endogenous S-nitrosothiols. J Mater Chem B. 9(4): 1059-1068. https://doi.org/10.1039/D0TB02709J; PMid:33400757
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Paediatric Surgery (Ukraine)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “PAEDIATRIC SURGERY. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “PAEDIATRIC SURGERY.UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
