Lipoperoxidation and Protein Oxidative Damage Exhibit Different Kinetics During Septic Shock

Septic shock (SS)-related multiorgan dysfunction has been associated with oxidative damage, but little is known about the temporal damage profile and its relationship to severity. The present work investigated prospectively 21 SS patients. Blood samples were obtained at diagnosis, 24, 72 hours, day 7, and at 3 months. At admission, thiobarbituric acid reactive substances (TBARSs), plasma protein carbonyls, plasma protein methionine sulfoxide (MS), ferric/reducing antioxidant power (FRAP), total red blood cell glutathione (RBCG), uric acid (UA), and bilirrubin levels were increased (P < .05). Total radical—trapping antioxidant potential (TRAP) and vitamin-E were similar to controls, and vitamin-C was decreased (P < .05). During evolution, TBARS and RBCG increased (P < .001), vitamin-E levels remained stable, whereas plasma protein carbonyls and MS, TRAP, vitamin-C, reduced glutathione, and UA levels decreased (P < .006). After 3 months, plasma protein carbonyls and MS persisted elevated. More severe patients exhibited higher TBARS, TRAP, FRAP, vitamin-C, UA, and bilirrubin levels. Our results suggest early and persistent oxidative stress during septic shock and a correlation between increasing levels of lipoperoxidation and sepsis severity.

[1]  Arlan Richardson,et al.  Methionine oxidation and aging. , 2005, Biochimica et biophysica acta.

[2]  A. Gabrielli,et al.  Oxidant injury occurs rapidly after cardiac arrest, cardiopulmonary resuscitation, and reperfusion* , 2005, Critical care medicine.

[3]  W. Knaus,et al.  Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. 1992. , 2009, Chest.

[4]  K. Reinhart,et al.  Total plasma antioxidant capacity is not always decreased in sepsis. , 1998, Critical care medicine.

[5]  B. Ames,et al.  Measurement of antioxidants in human blood plasma. , 1994, Methods in enzymology.

[6]  A. Schmedes,et al.  A new thiobarbituric acid (TBA) method for determining free malondialdehyde (MDA) and hydroperoxides selectively as a measure of lipid peroxidation , 1989 .

[7]  S. Colowick,et al.  Methods in Enzymology , Vol , 1966 .

[8]  M. Davies,et al.  Xanthine oxidase activity and free radical generation in patients with sepsis syndrome. , 1996, Critical care medicine.

[9]  D. Jacob,et al.  Evolution of the Archaean crust by delamination and shallow subduction , 2003, Nature.

[10]  A. Bodenham,et al.  Total vitamin C, ascorbic acid, and dehydroascorbic acid concentrations in plasma of critically ill patients. , 1996, The American journal of clinical nutrition.

[11]  W. Vogt.  Oxidation of methionyl residues in proteins: tools, targets, and reversal. , 1995, Free radical biology & medicine.

[12]  M. Tomaro,et al.  Bilirubin and ferritin as protectors against hemin-induced oxidative stress in rat liver. , 2002, Cellular and molecular biology.

[13]  Jackob Moskovitz,et al.  Methionine sulfoxide reductases: ubiquitous enzymes involved in antioxidant defense, protein regulation, and prevention of aging-associated diseases. , 2005, Biochimica et biophysica acta.

[14]  D. Menon,et al.  Plasma antioxidant potential in severe sepsis: a comparison of survivors and nonsurvivors. , 1996, Critical care medicine.

[15]  L. Carbonell,et al.  Oxidative stress in critically ill patients with systemic inflammatory response syndrome , 2002, Critical care medicine.

[16]  P. Howdle,et al.  Decreased antioxidant status and increased lipid peroxidation in patients with septic shock and secondary organ dysfunction. , 1995, Critical care medicine.

[17]  H. Ogawa,et al.  Possible role of increased oxidant stress in multiple organ failure after systemic inflammatory response syndrome , 2003, Critical care medicine.

[18]  L. Hor,et al.  Serum total antioxidant capacity reflects severity of illness in patients with severe sepsis , 2006, Critical care.

[19]  E. Lissi,et al.  Evaluation of total antioxidant potential (TRAP) and total antioxidant reactivity from luminol-enhanced chemiluminescence measurements. , 1995, Free radical biology & medicine.

[20]  D. Schneider,et al.  Low blood glutathione levels in healthy aging adults. , 1992, The Journal of laboratory and clinical medicine.

[21]  J. Windsor,et al.  Protein carbonyl measurements show evidence of early oxidative stress in critically ill patients , 2000, Critical care medicine.

[22]  F. Lu,et al.  Is the endogenous peroxyl-radical scavenging capacity of plasma protective in systemic inflammatory disorders in humans? , 2000, Free radical biology & medicine.

[23]  J. E. Carceller.  American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis , 1992, Critical care medicine.

[24]  E. Komives,et al.  Structural and functional consequences of methionine oxidation in thrombomodulin. , 2005, Biochimica et biophysica acta.

[25]  M. De la Fuente,et al.  Immune cells: free radicals and antioxidants in sepsis. , 2004, International immunopharmacology.

[26]  W. Knaus,et al.  Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. , 1992, Chest.

[27]  R. de la Fuente,et al.  Management of septic shock with a norepinephrine-based haemodynamic algorithm. , 2005, Resuscitation.

[28]  T. Koch,et al.  Antioxidant status in patients with acute respiratory distress syndrome , 1999, Intensive Care Medicine.

[29]  F. Markowetz,et al.  Acetylcysteine for prevention of contrast nephropathy: meta-analysis , 2003, The Lancet.

[30]  P. Howdle,et al.  The effects of intravenous antioxidants in patients with septic shock. , 1997, Free radical biology & medicine.

[31]  M. De la Fuente,et al.  Several functions of immune cells in mice changed by oxidative stress caused by endotoxin. , 2003, Physiological research.

[32]  Y. Shimada,et al.  Plasma lipid peroxides and alpha‐tocopherol in critically ill patients , 1984, Critical care medicine.

[33]  J. Windsor,et al.  Proteolysis in severe sepsis is related to oxidation of plasma protein. , 2002, The European journal of surgery = Acta chirurgica.

[34]  P. Caliceti,et al.  Protective effect of superoxide dismutase and polyethylene glycol-linked superoxide dismutase against renal warm ischemia/reperfusion injury. , 1996, Transplantation.

[35]  C. Winterbourn,et al.  Protein carbonyl measurement by a sensitive ELISA method. , 1997, Free radical biology & medicine.

[36]  D. Williams,et al.  A rapid manual method for routine assay of ascorbic acid in serum and plasma. , 1979, Clinical biochemistry.

[37]  J. Strain,et al.  Ferric reducing/antioxidant power assay: direct measure of total antioxidant activity of biological fluids and modified version for simultaneous measurement of total antioxidant power and ascorbic acid concentration. , 1999, Methods in enzymology.

[38]  Ohad Parnes,et al.  Inflammation , 2008, The Lancet.

[39]  D. Webb,et al.  Uric acid reduces exercise-induced oxidative stress in healthy adults. , 2003, Clinical science.

[40]  L. Ridnour,et al.  Measurement of glutathione, glutathione disulfide, and other thiols in mammalian cell and tissue homogenates using high-performance liquid chromatography separation of N-(1-pyrenyl)maleimide derivatives. , 1999, Methods in enzymology.

[41]  Y. Naito,et al.  Ischemia-reperfusion injury and free radical involvement in gastric mucosal disorders. , 1992, Advances in experimental medicine and biology.

[42]  M. Davies,et al.  Increased levels of serum protein oxidation and correlation with disease activity in systemic lupus erythematosus. , 2005, Arthritis and rheumatism.