alexa Evaluation of lipid peroxidation product, nitrite and antioxidant levels in newly diagnosed and two months follow-up patients with pulmonary tuberculosis.
Pulmonology

Pulmonology

Journal of Pulmonary & Respiratory Medicine

Author(s): Lamsal M, Gautam N, Bhatta N, Toora BD, Bhattacharya SK,

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Abstract This case-control study followed by a longitudinal cohort study was undertaken to evaluate the level of lipid peroxidation product malondialdehyde (MDA) and nitrite as an indirect measurement of nitric oxide vis-à-vis the levels of antioxidants vitamin C and vitamin E in pulmonary tuberculosis. Fifty-six sputum smear-positive cases of pulmonary tuberculosis based on Ziehl-Neelsen (ZN) staining and 50 healthy controls without any systemic disease were included in this study. Thirty-five cases were longitudinally followed up with standard antituberculosis chemotherapy (ATT) for two months. Serum levels of malondiadehyde (MDA), nitrite, and plasma levels of vitamins C and E were measured. The mean serum MDA level was significantly higher (8.1 +/- 1.61 nmoles/ml) in PTB patients before commencement of ATT as compared to healthy controls (3.45 +/- 1.7 nmoles/ml) (p=0.0001) and decreased significantly after 2 months of ATT (3.84 +/- 1.28 nmoles/ml) (p=0.0001). The mean serum nitrite level (47.19 +/- 18.44 micromol/l) was significantly elevated before ATT compared to healthy controls (32.89 +/- 11.94 micromoles/l) and decreased significantly after 2 months of ATT (27.71 +/- 11.97 micromoles/l) (p=0.0001). The mean plasma levels of vitamins C (0.88 +/- 0.33 mg/dl) and E (0.79 +/- 0.24 mg/dl) in PTB patients before commencement of ATT were lower than healthy controls (1.42 +/- 0.38 mg/dl) and (1.35 +/- 0.35 mg/dl), respectively (p=0.001). There was a significant increase in vitamin C levels after 2 months of ATT (1.19 +/- 0.40 mg/dl) compared to before ATT (0.83 +/- 0.31 mg/dl) (p=0.0001), but no significant change in mean plasma vitamin E level before and after 2 months on ATT was found. Elevated malondialdehyde and nitrite levels with concomitant depressed vitamin C and E levels are indicative of lipid peroxidation and oxidative stress. The decrease in levels of malondialdehyde and nitrite with subsequent increase in vitamin C levels after two months of follow-up indicate a good response to treatment with standard ATT. Hence, the extent of oxidative stress in PTB can be evaluated by analyzing lipid peroxidation product, antioxidant and nitric oxide levels.
This article was published in Southeast Asian J Trop Med Public Health and referenced in Journal of Pulmonary & Respiratory Medicine

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