Tehran University Medical Journal

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Background: Rheumatoid arthritis (RA) is an autoimmune disorder with unknown etiology. In recent years, a great number of studies have investigated the possible role of reactive oxygen species in the etiology and pathogenesis of Rheumatoid Arthritis. The aim of this study was to analyze the level of activities of catalase, glutathione peroxidas (GSH-Px), Super oxide dismotase (SOD) in patients with RA compared with the healthy subjects.
Methods: In a case-control study sixty rheumatoid arthritis patients 18-75 years old and 60 healthy sex and age-matched controls were selected, Catalase activity was measured by determining the constant rate (k) of hydrogen peroxide decomposition. GSH-Px activity of plasma was measured with spectrophotometer by Glutathione oxide generation due to GSH-Px. SOD activity is measured by degree of inhibition effect of SOD in generating super oxide radicals by xanthine and xanthine oxidase. C-reactive protein and rheumatoid factor values were determined by agglutination and latex tests.
Results: The plasma activity of catalase (p<0.001), GSH-Px (p<0.01), plasma level of hemoglobin and hematocrit (p<0.05) were significantly lower in patients with RA comparing with controls. The reduction in SOD activity was not significant (p>0.05). There was a negative significant relation between C reactive protein and Rheumatoid factor values with the erythrocyte activity of catalase and GSH-Px (p<0.01).
Conclusion: These results suggested that oxidative stress plays a very important role in the inflammation and pathogenesis of RA.

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Background: The cause of osteoporosis is multifactorial and many dietary factors are important in the prevention of this disease. Antioxidants as free radical scavengers may influence osteoporosis by reducing the effects of oxidative stress that may be associated with bone loss. Vitamin E is an important antioxidant that protects polyunsaturated fatty acids (PUFA) in cell membranes from oxidation. There are only two studies regarding vitamin E plasma levels in subjects suffering from osteoporosis. The purpose of this study was to investigate the association between plasma vitamin E levels and bone mineral density (BMD) in Iranian patients.
Methods: Subjects were consecutively recruited between May and September 2005 from among a total of approximately 1000 people referred for instrumental screening for osteoporosis to the Jami Clinic in Tehran. Inclusion criteria for the study group were: a femoral neck T-score of -1 or less, osteopenia, severe osteopenia and osteoporosis. A total of 137 subjects were enrolled. According to their femoral and spinal BMD scores, 54 persons were selected as a control group. The control group consisted of subjects with a femoral neck T-score and spine T-score of -1 or more. In selecting the case group, only the femoral BMD score was used. Plasma vitamin E was measured, after extraction with methanol, by HPLC with UV detection at 280 nm. Methanol, deionized water and butanol (90:4:6) was used as a mobile phase with a C8 column. The flow rate was 1.0 ml. min-1 and the acetate ester of vitamin E was used as an internal standard.
Results: The results show no significant difference in plasma vitamin E between the control and case groups, however linear regression analysis does reveal a significant difference between the T-score and plasma vitamin E.
Conclusion: Deceleration Femoral bone Density during osteoporosis will be Accelerated with Decrease of Vitamin E Antioxidant level.

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Background: The risk of atherosclerosis and cancer is high in hemodialysis (HD) patients. There is evidence that HD causes oxidative stress. However, the causative factors of oxidative stress are unknown. It has been suggested that HD imposes an additional oxidative stress on patients with chronic renal failure by activation of granulocytes on dialyzer membranes resulting in an imbalance between oxidants and antioxidants. In this regard, a number of reports, either measuring specific analytes or enzymes, or estimating the total antioxidant activity of the plasma have given contradictory and inconclusive results. To investigate the oxidative stress status in Iranian HD patients, in this study, we evaluated GSH and FRAP levels along with Ca and pH in the blood of these patients.

Methods: Along with 20 healthy age and gender matched control subjects, 24 patients underwent dialysis, three times per week, for four hours in each session. Before and after dialysis, blood was taken for biochemical and liver function tests and to evaluate oxidative stress markers and measure Ca and pH levels.

Results: There was a significant decrease in FRAP and GSH levels after dialysis compared to those before treatment. Dialysis caused an increase in pH and Ca levels compared to levels in control subjects after dialysis.

Conclusion: In general, before dialysis, there is a balance between oxidants and antioxidants however, due to higher levels of oxidants as well as the possible binding of antioxidants to the dialyzer membrane during dialysis, an imbalance occurs. The instability in the balance of oxidants and antioxidants may be the major cause of cellular oxidative damage found in HD patients. This study indicates that there is a significant level of oxidative stress in renal chronic patients and this stress is augmented by dialysis. Antioxidant therapy should be considered in these patients.

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Background: Acute lung injury (ALI) is a pulmonary pathology occuring in context of infection, trauma, burn, and sepsis. Tissue injury and release of chemical mediators result in tissue damage and organ failure especially respiratory failure. Many therapeutic modalities including vitamin E, allopurinol, and N-acetylcystein (NAC) have been used to decrease levels of inflammatory factors and to control and improve signs and symptoms. The antioxidant feature of NAC induces synthesis of glutathione- the scavenger of free radicals- and increase respiratory drive and PaO₂. In time diagnosis of ALI, prompt institution of treatment will reduce mortality and morbidity in critical illness.
Methods: This open label analytical clinical trial included a total of 50 patients admitted in the ICU ward of Sina University Hospital. They were randomly divided into two groups of 25, the case group received NAC 150mg/kg in 100ml Normal saline within 20 minutes then 50mg/kg in 100ml Normal saline within 4 hr after that 50mg/kg daily for three days. The controls received only normal saline. Oxygenation and ventilation parameters were studied In both groups.
Results: There were no significant difference between the groups in terms of demographic indices, mean SpO₂, ABG values, mortality rates, and clearing of chest x-rays. The best outcome was seen in young traumatic patients.

Conclusion: In this relatively small group of patients presenting with an established ALI/ ARDS subsequent to a variety of underlying disease, intravenous NAC treatment during first four days neither significantly improved systemic oxygenation nor reduced the need for ventilatory support.

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Background: Preeclampsia is a disorder of pregnancy with increased maternal and perinatal morbidity and mortality. An imbalance between free radical induced lipid peroxidation and antioxidant system has been suggested as possible pathogenesis of preeclapsia. It has been shown correlation of some serum antioxidant agents (for example ceruloplasmin) with preeclampsia and its severity. The purpose of this study was to evaluate of this correlation.

Methods: In a analytic case-control study, in clinic and delivery unit of Mirza Koochak Khan university hospital, Tehran, we evaluated 90 pregnant women of 19-38 years old with gestational age higher than 20 weeks in two groups, case (preeclampsia) and control (healty mother). Case group was devided into two groups mild preeclampsia (n=30) and severe preeclampsia (n=30). Patients with preeclampsia (n=60) had either early (n=41) or late preeclampsia (n=19). Control group included 30 normotensive pregnant women. Serum Ceruroplasmin level was measured. Then relationship between this factor and preeclampsia was studied.

Results: The mean level of serum ceruloplasmin in women with severe preeclampsia (390.83mg/dl) and mild preeclampsia (319.43mg/dl) was higher than control group (212.7mg/dl). Likewise it was significantly higher in severe preeclampsia than mild (P<0.001) and higher in early (373.28mg/dl) than late preeclampsi (298.34mg/dl) (P<0.01).

Conclusions: Our data suggest that serum ceruroplasmin level may predict preeclampsia occurrance and its severity. Likewise antioxidant theryapy before the onset of preeclampsia in an attempt to decrease its frequency should be considered.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Defective sperm function is now recognized as one of the most important causes of male infertility. Seminal plasma possesses a rich source of different enzymatic and non-enzymatic antioxidants such as vitamin C (ascorbic acid) that protect spermatozoa against oxidative stress as one of the mediators of infertility causing sperm dysfunction and low sperm quality. The aim of this study was investigation of seminal total antioxidant capacity and determination of vitamin C effects on sperm motility.

Methods: We designed a case-control study with a total subject of 62 males. Sperm parameters were analyzed according to World Health Organization guidelines (WHO, 1999). Total antioxidant capacity and vitamin C level of seminal plasma were measured in the 32 normozoospermic as the control group and 32 asthenospermic men as the case group using FRAP (Ferric Reducing of Antioxidants Powers) and RP-HPLC (Reverse Phase High Performance Liquid Chromatography) methods, respectively.

Results: Our results indicated that total antioxidant capacity levels in the seminal plasma of asthenospermic men were significantly lower than healthy men (p=0.002). In addition, we found a positive correlation between reduced total antioxidant capacity levels and low sperm motility. Vitamin C levels of seminal plasma in asthenospermic men were statistically lower than control men (p=0.01).

Conclusions: It is suggested that asthenospermia could be related to an antioxidant deficiency or it&aposs reduction.

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Background: Many chemotherapeutic regimens used in the treatment of cancer generate free radicals that may be a part of their beneficial effects. The aim of this study was to assess the oxidative status in patients undergoing chemotherapy for acute myeloid leukemia (AML).

Methods: Thirty-eight patients with AML (17 female and 21 male patients) with a mean age 34.05±12.49 years were included in the study. All the patients received cytarabine and daunorubicin as their standard induction therapy. Serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), and also the erythrocyte superoxide dismutase and glutathione peroxidase activities were measured before and 14 days after chemotherapy.

Results: Plasma malondialdehyde concentrations increased significantly (from a former 2.68±0.89 nmol/ml to 3.14±1.29 nmol/ml) 14 days post chemotherapy (p=0.04). Moreover, the total plasma antioxidant capacity changed from 1.09±0.15 mmol/L to 1.02±0.14 mmol/L (p=0.005). Erythrocyte superoxide dismutase and glutathione peroxidase activity decreased over time from 1157.24±543.61 U/gHb to 984.01±419.09 U/gHb (p=0.04) and 46.96±13.70 U/gHb to 41.40±6.44 U/gHb (p=0.02), respectively.

Conclusion: In this study, an increase in malondialdehyde levels and a decrease in the levels of antioxidant enzymes and total antioxidant capacity were observed. It seems that chemotherapy by cytarabine and daunorubicin generates enormous amounts of free radicals in patients undergoing the treatment for AML. Use of antioxidant supplementation during chemotherapy i is discouraged as it may interfere with the generation of free radicals that may be a part of the therapeutic efficacy of these drugs.

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Background: Recurrent aphthous stomatitis (RAS) is a common disease with unknown etiology. There is no curative treatment. Purslane is considered as a rich source of antioxidants with anti-inflammatory effects. The purpose of this study is to evaluate the effect of Purslane in the treatment of RAS.
Methods: A total of 50 patients were selected for this randomized triple-blind placebo-controlled clinical trial from School of Dentistry of Tehran University of Medical Sciences in 2011. All subjects were randomly divided into two groups. Groups A and B received placebo and Purslane, respectively, for three months. Pain intensity based on the visual analogue scale (VAS), the mean intervals of lesions occurrence, number of lesions and the mean duration of complete healing at baseline and at months 1, 2 and 3 were recorded. 
Results: While no patient complained from increased severity of pain, decreased severity of pain for 4, 3, 2, and 1 grades were recorded in %16, %20, 20%, and 40%, respectively, which were much higher than 4%, 8%, 8%, and 28%, respectively, in the control group. A significant decrease in pain intensity in VAS scores were seen after treatment in group B (P<0.001). The mean duration of complete healing showed significant differences (P<0.001) between groups A (-1.52±4.07 days) and group B (-6.56±4.50 days). The mean intervals between lesions also showed significant differences (P<0.001) between group A (17.88 days) and group B (33.12 days). No significant differences were found between group A and group B regarding to number of lesions. No serious side-effects occurred in either group.
Conclusion: According to our study, Purslane is clinically effective in treatment of RAS and considering the lack of side-effects during the study period, this medicine may be a favorable alternative treatment for recurrent aphthous stomatitis.

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Background: Postpartum depression (PPD) is a major depressive disorder and one of the most common complications of childbearing. PPD has a serious impact on the quality of life of all family members. Oxidative stress is one of the contributing factors in pathophysiology of major depression. Thus, drugs with potential antioxidant action could be an attractive target for treatment of depressive disorders. Matricaria Chamomilla and Selenium are natural sources of antioxidant. The aim of this study was to evaluate effects of oral administration of Matricaria Chamomilla aqueous extract and Selenium on experimental model of progesterone-induced postpartum depression and plasma oxidant-antioxidant system in mice. Methods: Seventy adult female mice in seven groups were used in this study. All animals received daily injections of progesterone 5 mg/kg intraperitoneally for five days after which progesterone was withdrawn for three days. After modelling postpartum depression with progesterone withdrawal, Matricaria Chamomilla 300 mg/kg and Selenium 0.1 mg/kg and their combination were administered via gavage and imipramine 15 mg/kg was administered intraperitoneally one hour before open field and forced swimming test (FST). In order to investigate the role of oxidant-antioxidant system, PAB and MDA were meatured. Results: All the treatment groups and the standard group spent less immobility time than the control group (P<0.05). Significant changes in the oxidative parameter (PAB and MDA) were not observed in all treatment groups and the standard group compared to the control group. Conclusion: Our study demonstrated the potential antidepressant activity of Matricaria chamomilla and Selenium in the experimental model of progesterone-induced postpartum depression in mice. These elements as supplement compounds could be alternatives for antidepressants in postpartum period. It seems that the antidepresent effects of this compounds do not induced by effects on oxidant-antioxidant system and may exert through any other pathway.

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Background: Approximately 50% to 80% of women experience varying degrees of postpartum depression. Oxidative stress is involved in many diseases, including depression. Common production of lipid peroxidation by oxidative stress is malondialdehyde (MDA). The endocannabinoid system is a nervous regulator and convoy the impression that the circulatory levels of endocannabinoid is significantly reduced in depressed women. The major purpose of this paper was to evaluate activity of the major antioxidant and endocannabinoid index in postpartum depression. Methods: A total of 130 women were entered in a case-control study in 12 Bahman Health Center from April 2011 to August 2011. In 4th to 6th week after delivery, women were equally divided into 2 groups based on Edinburg questionnaire (normal and postpartum depressive women). Serum MDA, total antioxidant capacity (TAC) and RBC catalase levels were determined to investigate the oxidative status. In addition, Mass spectrometry was applied for the analysis of serum anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). Results: Based on Edinburg questionnaire, however, women age, husband age, husband marital number, gravidity, children number, salary and house size have no significant effect on postpartum depression, marital period was significantly increased postpartum depression (P< 0.05). In addition, women education, husband education, wanted or unwanted pregnancy from women, neonatal sex, satisfaction of neonatal sex from women and husbands, breast feeding and delivery have no significant effect on postpartum depression, and women Job (P< 0.001), husband job (P< 0.001), wanted or unwanted pregnancy from husbands (P< 0.05) were significantly changed postpartum depression. Serum MDA and RBC catalase levels were not significantly higher in depress compared with the normal group. TAC was significantly decreased in patients having postpartum depression (P< 0.05). Serum AEA and 2-AG levels were significantly lower in depress compared with the normal group (P< 0.01). Conclusion: Women’s Job, husband’s job, wanted or unwanted pregnancy from husbands and marital period are associated to postpartum depression. In postpartum depression, TAC, AEA and 2-AG are reduced. So it can be concluded that both antioxidant system and endocannabinoid concentration involved in the development of postpartum depression.

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Background: Aloysia citrodora belongs to the Verbenaceae family of plants, a well-known herbal medicine in Iran. The aim of the present study was to investigate the chemical composition, antioxidant, antibacterial, cytotoxic and apoptotic effect of A. citrodora extract against human colon cancer (HT29) cells by using real-time polymerase chain reaction and flow-cytometry methods.

Methods: This experimental study was carried out in Islamic Azad University, East Tehran Branch, from March to September of 2014. At first, the A. citrodora chemical constituents were analyzed by gas chromatography-mass spectrometry (GC-MS) technique. In addition, antioxidant assay, antibacterial and anti-cancer effect was performed using 1,1-diphenyl-2-picrylhydrazyl (DPPH), disk diffusion and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) methods, respectively. The half maximal inhibitory concentration (IC50) value was calculated. We extracted total RNA molecules by using RNX solution, after which cDNA was synthesized. Finally, the pro-apoptotic (Bax) and anti-apoptotic (Bcl2) gene expression was performed by real-time polymerase chain reaction and apoptotic effects were analyzed using Flow-cytometry method.

Results: GC-MS analysis of Aloysia citrodora extract was shown 37 major components and the most frequent component was belonged to Spathulenol (17.57%) and Caryophyllene oxide (15.15%) The antioxidant activity of the extract was IC50= 0.6±0.03 mg/ml. The maximum and minimum antibacterial effects of extract were belonged to gram-negative and gram-positive bacteria, respectively. Cytotoxic results revealed that the A.citrodora extract have IC50= 20.1±0.78 mg/ml against colon cancer (HT29) cell line and real-time polymerase chain reaction results showed the expression level of Bax and Bcl2 was increased and decreased respectively in colon cancer cell line (3.470±0.72 (P< 0.05), 0.43±0.35 (P< 0.05)). In addition, the flow-cytometry results indicated the 38.66% apoptosis in colon cancer cell line.

Conclusion: According to the results, it seems that A. citrodora extract has potential antioxidant, antibacterial and anticancer effects and it suggested that further studies were performed for A. citrodora pharmaceutical importance.

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