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Tsinari A, Roumeliotis S, Neofytou IE, Varouktsi G, Veljkovic A, Stamou A, Leivaditis K, Liakopoulos V. The Clinical Utility and Plausibility of Oxidative and Antioxidant Variables in Chronic and End-Stage Kidney Disease: A Review of the Literature. Int J Mol Sci 2025; 26:3376. [PMID: 40244241 PMCID: PMC11989862 DOI: 10.3390/ijms26073376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Revised: 03/31/2025] [Accepted: 04/02/2025] [Indexed: 04/18/2025] Open
Abstract
Oxidative stress (OS) is caused by an imbalance between the production of reactive oxygen species (ROS) in cells and tissues and the ability of the biological system to detoxify these products. In chronic kidney disease (CKD), OS contributes to deterioration of kidney function and disease progression. In patients with end-stage kidney disease undergoing hemodialysis or peritoneal dialysis, OS is further increased and associated with adverse clinical outcomes, including deterioration and subsequent loss of residual renal function, atherosclerosis, hypertension, cardiovascular disease and death. However, currently, there is no consensus or guidelines for the diagnosis and treatment of OS in these patients. Herein, we aim to present the existing data regarding biomarkers of OS, pro-oxidants (oxidized albumin, advanced oxidation protein products, xanthine oxidase/dehydrogenase, nitrite/nitrate, malondialdehyde) and antioxidants (superoxide dismutase, catalase, vitamin E, total antioxidant capacity, N-acetylcysteine) that are most clinically relevant and have been more extensively studied in patients with chronic kidney disease, aiming to provide a clearer understanding of this complex area.
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Affiliation(s)
- Ariti Tsinari
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
| | - Stefanos Roumeliotis
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
| | - Ioannis E. Neofytou
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
| | - Garyfallia Varouktsi
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
| | - Andrej Veljkovic
- Department of Biochemistry, Faculty of Medicine, University of Niš, 18000 Niš, Serbia;
| | - Aikaterini Stamou
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
| | - Konstantinos Leivaditis
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
| | - Vassilios Liakopoulos
- 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (A.T.); (I.E.N.); (G.V.); (A.S.); (K.L.); (V.L.)
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Szulimowska J, Zalewska A, Taranta-Janusz K, Trocka D, Żendzian-Piotrowska M, Tomasiuk R, Maciejczyk M. Association of Ischemia-Modified Albumin (IMA) in Saliva, Serum, and Urine with Diagnosis of Chronic Kidney Disease (CKD) in Children: A Case-Control Study. Med Sci Monit 2023; 29:e942230. [PMID: 38093614 PMCID: PMC10729497 DOI: 10.12659/msm.942230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Ischemia-modified albumin (IMA) is a secreted biomarker for ischemic oxidative stress. This case-control study aimed to evaluate the association of ischemia-modified albumin (IMA) in saliva, serum, and urine with diagnosis of chronic kidney disease (CKD) in 24 children. MATERIAL AND METHODS The study involved 24 children with CKD. CKD was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) diagnostic criteria. The control group consisted of 24 healthy children who were matched for age and gender to the experimental group. The concentration of IMA was determined by the colorimetric method in non-stimulated whole saliva (NWS), stimulated whole saliva (SWS), serum, and urine of children with CKD. The Mann-Whitney U test was used for inter-group comparisons. RESULTS IMA levels were significantly higher in NWS (P=0.0082) and SWS (P=0.0014) of children with CKD than in the control group. The concentration of IMA in NWS was correlated with standard indicators of kidney function, including the estimated glomerular filtration rate (r=-0.798, P≤0.0001), stage of CKD (r=0.814, P≤0.0001), and serum creatinine (r=0.711, P≤0.0001) and urea levels (r=0.738, P≤0.0001). CONCLUSIONS Salivary IMA concentration depends on renal function in children. Salivary IMA discriminates children with end-stage kidney disease from children with mild and moderate CKD and healthy children with high sensitivity and specificity. Further research is required, including assessment of the diagnostic usefulness and validation of the biomarker in a clinical diagnostic study.
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Affiliation(s)
- Julita Szulimowska
- Department of Conservative Dentistry, Medical University of Białystok, Białystok, Poland
| | - Anna Zalewska
- Department of Conservative Dentistry, Medical University of Białystok, Białystok, Poland
| | | | - Daria Trocka
- Students’ Scientific Club “Biochemistry of Civilization Diseases” at the Department of Hygiene, Epidemiology and Ergonomics, Medical University of Białystok, Białystok, Poland
| | | | - Ryszard Tomasiuk
- Department of Medicine, Faculty of Medical Sciences and Health Sciences, Kazimierz Pułaski University in Radom, Radom, Poland
| | - Mateusz Maciejczyk
- Department of Hygiene, Epidemiology and Ergonomics, Medical University of Białystok, Białystok, Białystok, Poland
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Coverdale JPC, Katundu KGH, Sobczak AIS, Arya S, Blindauer CA, Stewart AJ. Ischemia-modified albumin: Crosstalk between fatty acid and cobalt binding. Prostaglandins Leukot Essent Fatty Acids 2018; 135:147-157. [PMID: 30103926 PMCID: PMC6109191 DOI: 10.1016/j.plefa.2018.07.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 02/06/2023]
Abstract
Myocardial ischemia is difficult to diagnose effectively with still few well-defined biochemical markers for identification in advance, or in the absence of myocardial necrosis. "Ischemia-modified albumin" (IMA), a form of albumin displaying reduced cobalt-binding affinity, is significantly elevated in ischemic patients, and the albumin cobalt-binding (ACB) assay can measure its level indirectly. Elucidating the molecular mechanism underlying the identity of IMA and the ACB assay hinges on understanding metal-binding properties of albumin. Albumin binds most metal ions and harbours four primary metal binding sites: site A, site B, the N-terminal site (NTS), and the free thiol at Cys34. Previous efforts to clarify the identity of IMA and the causes for its reduced cobalt-binding capacity were focused on the NTS site, but the degree of N-terminal modification could not be correlated to the presence of ischemia. More recent work suggested that Co2+ ions as used in the ACB assay bind preferentially to site B, then to site A, and finally to the NTS. This insight paved the way for a new consistent molecular basis of the ACB assay: albumin is also the main plasma carrier for free fatty acids (FFAs), and binding of a fatty acid to the high-affinity site FA2 results in conformational changes in albumin which prevent metal binding at site A and partially at site B. Thus, this review advances the hypothesis that high IMA levels in myocardial ischemia and many other conditions originate from high plasma FFA levels hampering the binding of Co2+ to sites A and/or B. This is supported by biophysical studies and the co-association of a range of pathological conditions with positive ACB assays and high plasma FFA levels.
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Affiliation(s)
| | - Kondwani G H Katundu
- School of Medicine, University of St Andrews, St Andrews, United Kingdom; College of Medicine, University of Malawi, Blantyre, Malawi
| | - Amélie I S Sobczak
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Swati Arya
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | | | - Alan J Stewart
- School of Medicine, University of St Andrews, St Andrews, United Kingdom.
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Abstract
Abstract
Purpose: Acute kidney injury (AKI) is a severe kidney disease carrying high morbidity and mortality. An ischemic process, at the cellular level, has been detected prior to the full-blown AKI. An elevated ischemic modified albumin (IMA) was also found to be increased fast at several minutes following an ischemic process in the body. In this connection, we have investigated, in advance, the changes of IMA concentrations in patients with possible AKI. Methods: IMA and other biochemical and haematological parameters were measured in sera of thirty nine patients with AKI and of thirty eight healthy controls. AKI is defined by an increase in serum creatinine by ≥ 0.3 mg/dl in 48 hours or an increase by ≥ 1.5-fold from a known or assumed baseline. The results in the two groups were compared. Results: IMA, creatinine, blood urea nitrogen, white blood cell, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume were found to be higher in patients with AKI than in healthy controls. In contrast, total protein, albumin, lymphocyte, and haemoglobin were lower in patients with AKI than in healthy controls. No significant difference was recorded in platelet counts between the two groups. Conclusion: Our results indicate that increased levels of NLR and PLR play a central role in a systemic inflammation in AKI. Monitoring serum IMA could be a useful tool in the assessment of AKI.
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Bilgi M, Keser A, Katlandur H, Sahin E, Kalkan AO, Yildiz M, Kiyici A, Keles M. Evaluation of the Relationship Between Microalbuminuria and Urine Ischemia-Modified Albumin Levels in Patients with Diabetic Nephropathy. J Clin Lab Anal 2016; 31. [PMID: 27696561 PMCID: PMC6817056 DOI: 10.1002/jcla.22058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 07/31/2016] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ischemia-modified albumin (IMA) is a marker which can be associated with oxidative stress in various ischemic and non-ischemic processes. Oxidative stress plays roles in diabetes mellitus, its complications and pathogenesis. Serum IMA levels are examined in various clinical events. However, urine IMA levels have not yet been evaluated in diabetic patients. In this study, we aim to examine the relationship between metabolic features and urine microalbuminuria levels of diabetic patients and their urine IMA levels. MATERIALS AND METHODS There were totally 50 type 2 diabetic patients in the study at the Mevlana University Hospital. Patients with cerebrovascular disease, acute myocardial infarction, hemodialysis patients with end stage chronic renal failure, pulmonary embolism, and malignant disease were excluded from the study. Metabolic features, urine IMA levels and cardiological parameters of patients were evaluated. RESULTS Mean age of patients was 59 ± 9 years, 20 of them (40%) were male and 30 of them (60%) were female. There were six patients with albuminuria value of <0.03 mg/g (normal), there were 39 patients with microalbuminuria value of 0.03-0.3 mg/g and there were five patients with macroalbuminuria of >0.3 mg/g. According to the analysis of patients with microalbuminuria (n = 39), there was no correlation between IMA levels and numerical demographic data, albuminuria, glucose, HbA1c, lipid profile, creatinine, uric acid, hematological parameters. DISCUSSION Conclusively, there was no relationship between urine IMA levels and microalbuminuria related to the diabetic nephropathy. These findings can be associated with urinary excretion mechanisms of IMA.
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Affiliation(s)
- Mustafa Bilgi
- Department of Internal Medicine, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Ahmet Keser
- Department of Cardiology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Huseyin Katlandur
- Department of Cardiology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Emel Sahin
- Department of Biochemistry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Ali Osman Kalkan
- Department of Internal Medicine, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Murat Yildiz
- Department of Internal Medicine, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Aysel Kiyici
- Department of Biochemistry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Mustafa Keles
- Department of Nephrology, Faculty of Medicine, Mevlana University, Konya, Turkey
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Ozgen SU, Ozveren B, Kilercik M, Aksu U, Ay B, Tufek I, Kural AR, Turkeri LN, Toraman F. Ischemia modified albumin: does it change during pneumoperitoneum in robotic prostatectomies? Int Braz J Urol 2016; 42:69-77. [PMID: 27136469 PMCID: PMC4811228 DOI: 10.1590/s1677-5538.ibju.2014.0677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 08/15/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The unique positioning of the patient at steep Trendelenburg with prolonged and increased intra-abdominal pressure (IAP) during robotic radical prostatectomy may increase the risk of splanchnic ischemia. We aimed to investigate the acute effects of IAP and steep Trendelenburg position on the level of ischemia modified albumin (IMA) and to test if serum IMA levels might be used as a surrogate marker for possible covert ischemia during robotic radical prostatectomies. PATIENTS AND METHODS Fifty ASA I-II patients scheduled for elective robotic radical prostatectomy were included in this investigation. EXCLUSION CRITERIA The patients were excluded from the study when an arterial cannulation could not be accomplished, if the case had to be converted to open surgery or if the calculated intraoperative bleeding exceeded 300ml. All the patients were placed in steep (45 degrees) Trendelenburg position following trocar placement. Throughout the operation the IAP was maintained between 11-14mmHg. Mean arterial blood pressure (MAP), cardiac output (CO) were continuously monitored before the induction and throughout the surgery. Blood gases, electrolytes, urea, creatinine, alanine transferase (ALT), aspartate transferase (AST) were recorded. Additionally, IMA levels were measured before, during and after surgery. RESULTS (1) MAP, CO, lactate and hemoglobin (Hb) did not significantly change in any period of surgery (p>0.05); (2) sodium (p<0.01), potassium (p<0.05) and urea (p<0.05) levels decreased at postoperative period, and no significant changes at creatinine, AST, ALT levels were observed in these patients; (3) At the end of surgery (180 min) pCO2, pO2, HCO3 and BE did not change compared to after induction values (p>0.05) but mild acidosis was present in these patients (p<0.01 vs. after induction); (4) IMA levels were found to be comparable before induction (0.34±0.04), after induction (0.31±0.06) and at the end of surgery (0.29±0.05) as well. CONCLUSION We did not demonstrate any significant mesenteric-splanchnic ischemia which could be detected by serum IMA levels during robotic radical prostatectomies performed under steep Trendelenburg position and when IAP is maintained in between 11-14 mmHg.
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Affiliation(s)
- Serpil Ustalar Ozgen
- Department of Anesthesiology and Reanimation, Acibadem University, Istanbul, Turkey
| | - Bora Ozveren
- Department of Urology, Acibadem University, Istanbul, Turkey
| | | | - Ugur Aksu
- Department of Biology, Faculty of Science, Istanbul University, Istanbul, Turkey
| | - Binnaz Ay
- Department of Anesthesiology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Ilter Tufek
- Department of Urology, Acibadem University, Istanbul, Turkey
| | - Ali Riza Kural
- Clinics of Urology, Acibadem Maslak Hospital, Istanbul, Turkey
| | | | - Fevzi Toraman
- Department of Anesthesiology and Reanimation, Acibadem University, Istanbul, Turkey
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Karamanli H, Kiyici A, Arik B, Efe D, Akgedik R. Influence of obstructive sleep apnea on ischemia-modified albumin levels and carotid intima-media thickness. J Investig Med 2016; 64:1035-41. [PMID: 27029471 DOI: 10.1136/jim-2016-000063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2016] [Indexed: 12/22/2022]
Abstract
Obstructive sleep apnea (OSA) is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (CIMT) is strongly associated with the presence of significant risk factors for cardiovascular disturbances. A disturbance in the oxidative/antioxidative balance is involved in the pathogenesis of OSA and cardiovascular diseases. Ischemia-modified albumin (IMA) is suggested as a novel marker of oxidative stress; IMA can be defined as decreased binding of transitional metal ions to serum albumin in oxidative status. The purpose of this research was to evaluate the influence of OSA on IMA levels and CIMT. In total, 61 individuals with OSA with no comorbidities and 24 healthy controls with a similar body mass index and age were enrolled in this study. Serum levels of IMA, CIMT (estimated radiologically), and polysomnographic parameters, were determined and interpreted. Serum IMA levels were significantly higher in individuals with OSA compared with the control group (p=0.0003). CIMT was significantly higher in the OSA group compared with the control group (0.88± 0.26 mm vs 0.75±0.17 mm, p=0.005). The CIMT and serum IMA levels were positively correlated with the apnea-hypopnea index (r=0.35 and r=0.32, respectively), and with the oxygen desaturation index (r=0.34 and r=0.29, respectively) at baseline. Increased IMA levels and CIMT may be related to increased oxidative stress and risk of atherosclerosis in individuals with OSA.
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Affiliation(s)
- Harun Karamanli
- Department of Pulmonology, Ataturk Chest and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Aysel Kiyici
- Department of Biochemistry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Bilal Arik
- Department of Radiology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Duran Efe
- Department of Radiology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Recep Akgedik
- Department of Pulmonology, Faculty of Medicine, Ordu University, Ordu, Turkey
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Dadaci Z, Oncel M, Oncel Acir N, Sahin E, Borazan M. Oxidative stress parameters and serum magnesium levels in patients with seasonal allergic conjunctivitis. Cutan Ocul Toxicol 2015; 35:270-4. [PMID: 26555509 DOI: 10.3109/15569527.2015.1100634] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate oxidative stress parameters and serum magnesium (Mg) levels in patients with seasonal allergic conjunctivitis (SAC) during the pollen season. METHODS This observational cross-sectional study involved 35 patients with SAC without any other ocular and systemic diseases, and 38 consecutive, age- and sex-matched healthy subjects. Serum malondialdehyde (MDA), adjusted ischemia modified albumin (IMA), and Mg levels were quantified, and the results were compared between the groups. RESULTS No significant differences were found between the groups with respect to age (p = 0.416) and sex (p = 0.362). Serum MDA and adjusted IMA levels of the subjects with SAC (69.54 ± 7.71 μM and 0.74 ± 0.39 ABSU) were significantly higher than the control group (64.61 ± 5.89 μM and 0.57 ± 0.19 ABSU) (p = 0.002 and p = 0.025, respectively). There was no significant difference for serum Mg levels between the groups (p = 0.177). CONCLUSION We demonstrated higher levels of oxidative stress parameters in patients with SAC compared to the control group, which imply a possible role of oxidative stress in the pathogenesis of SAC.
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Affiliation(s)
- Zeynep Dadaci
- a Department of Ophthalmology , Mevlana (Rumi) University School of Medicine , Konya , Turkey and
| | - Mufide Oncel
- b Department of Clinical Biochemistry , Mevlana (Rumi) University School of Medicine , Konya , Turkey
| | - Nursen Oncel Acir
- a Department of Ophthalmology , Mevlana (Rumi) University School of Medicine , Konya , Turkey and
| | - Emel Sahin
- b Department of Clinical Biochemistry , Mevlana (Rumi) University School of Medicine , Konya , Turkey
| | - Mehmet Borazan
- a Department of Ophthalmology , Mevlana (Rumi) University School of Medicine , Konya , Turkey and
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Giannone FA, Domenicali M, Baldassarre M, Bartoletti M, Naldi M, Laggetta M, Bertucci C, Colecchia A, Viale P, Bernardi M, Caraceni P. Ischaemia-modified albumin: a marker of bacterial infection in hospitalized patients with cirrhosis. Liver Int 2015; 35:2425-32. [PMID: 25939693 DOI: 10.1111/liv.12860] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/26/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Patients with cirrhosis present structural changes of human serum albumin (HSA) affecting non-oncotic functions. Ischaemia-modified albumin (IMA), which reflects the capacity to bind cobalt, has been associated to patient mortality during acute-on-chronic liver failure. This study aimed to assess whether circulating IMA is elevated in advanced cirrhosis and its relationship with severity of cirrhosis and specific complications. METHODS A total of 127 cirrhotic patients hospitalized for an acute complication of the disease and 44 healthy controls were enrolled. Plasma IMA and IMA to albumin ratio (IMAr) were measured with a cobalt-binding assay. HSA isoforms carrying post-transcriptional molecular changes were assessed with HPLC-ESI-MS. The effect of endotoxemia on IMA was evaluated in rats with CCl4 -cirrhosis. RESULTS IMA/IMAr is significantly higher in cirrhotic patients than in controls, but no correlations were found with prognostic scores. IMA did not correlate with the altered HSA isoforms. Ascites, renal impairment and hepatic encephalopathy did not influence IMA/IMAr levels. In contrast, IMA/IMAr is significantly higher in infected than non-infected patients. ROC curves showed that IMA/IMAr had similar discriminating performances for bacterial infection as C-reactive protein (CRP). Moreover, CRP and IMA were independently associated with bacterial infection. Consistently, endotoxin injection significantly increased IMA in cirrhotic, but not in healthy rats. CONCLUSIONS IMA is elevated in patients with advanced cirrhosis. The IMA level does not correlate with disease severity scores, but it is specifically associated to bacterial infection, showing a discriminating performance similar to CRP. Further investigations to assess IMA as a novel diagnostic test for bacterial infection are advocated.
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Affiliation(s)
- Ferdinando A Giannone
- U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Marco Domenicali
- U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Maurizio Baldassarre
- U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Michele Bartoletti
- U.O. Infectious Diseases, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Marina Naldi
- Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy.,Department of Pharmacology and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maristella Laggetta
- U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Carlo Bertucci
- Department of Pharmacology and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Antonio Colecchia
- U.O. Gastroenterology, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pierluigi Viale
- U.O. Infectious Diseases, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Mauro Bernardi
- U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Paolo Caraceni
- U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Center for Applied Biomedical Research (C.R.B.A.), S.Orsola-Malpighi University Hospital, Bologna, Italy
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Amasyali AS, Akkurt A, Kazan E, Yilmaz M, Erol B, Yildiz Y, Erol H. The protective effect of tadalafil on IMA (ischemia modified albumin) levels in experimental renal ischemia-reperfusion injury. Int J Clin Exp Med 2015; 8:15766-15772. [PMID: 26629074 PMCID: PMC4658963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/09/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION To investigate the effect of the tadalafil in experimental renal I/R injury and to evaluate these changes with IMA (nonspesific early biomarker of ischemia), NO and MDA levels. MATERIALS AND METHODS Twenty four female Wistar rats were randomly divided into 3 groups (n=8): Group I, sham; Group II, 60 min I/R; Group III, 60 min I/R plus tadalafil. Tadalafil was administered via an orogastric tube (10 mg/kg) 24 h prior to the procedure. After ischemia of the left kidney and 1 h of reperfusion, blood samples were obtained, and the kidney was removed. RESULTS Statistically significant histopathologic changes were exist between groups, with the most severe injury was determined in group II in comparison to the others (X(2)=21,803, P=0.000). Also mean serum IMA levels were higher in group II, but not statistically significant (19.83±7.81 U/ml, 22.26±7.14 U/ml and 19.82±7.77 U/ml, P=0.613). In addition, NO values were lower in I/R groups (P=0.049). There were no differences among the groups in terms of MDA. CONCLUSIONS IMA may be used as a nonselective biomarker for IR injury before the occurrence of necrosis. Decreased IMA levels may indicate the nephroprotective effect of tadalafil in renal IR injury.
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Affiliation(s)
- Akin Soner Amasyali
- Department of Urology, School of Medicine, Adnan Menderes UniversityAydin, Turkey
| | - Abdullah Akkurt
- Department of Urology, School of Medicine, Adnan Menderes UniversityAydin, Turkey
| | - Ercan Kazan
- Department of Urology, School of Medicine, Adnan Menderes UniversityAydin, Turkey
| | - Mustafa Yilmaz
- Department of Biochemistry, School of Medicine, Adnan Menderes UniversityAydin, Turkey
| | - Bulent Erol
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet UniversityIstanbul, Turkey
| | - Yuksel Yildiz
- Department of Physiology School of Medicine, Adnan Menderes UniversityAydin, Turkey
| | - Haluk Erol
- Department of Urology, School of Medicine, Adnan Menderes UniversityAydin, Turkey
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Can Ischemia-Modified Albumin Be Used as an Objective Biomarker for Renal Ischemic Damage? An Experimental Study With Wistar Albino Rats. Transplant Proc 2014; 46:3326-9. [DOI: 10.1016/j.transproceed.2014.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Oncel M, Kıyıcı A, Onen S. Evaluation of the Relationship Between Ischemia-Modified Albumin Levels and Thyroid Hormone Levels. J Clin Lab Anal 2014; 29:427-31. [PMID: 24953331 DOI: 10.1002/jcla.21789] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 05/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A novel ischemia marker named ischemia modified albumin was previously considered as an early marker of myocardial ischemia, however due to recent reports, its contribution was demonstrated in different pathologies such as oxidative stress, diabetes, stroke and cancer. We aimed to investigate the relation between oxidative stress and thyroid dysfunctions determining IMA levels since IMA is closely related with increased oxidative stress. METHODS A total of 88 individuals were participated in this study: 34 cases in hypothyroid, 27 cases in hyperthyroid and 27 cases in euthyroid group. Ischemia-modified albumin levels were measured by albumin cobalt binding test and thyroid hormone levels were determined with electrochemiluminescent method. RESULTS Ischemia modified albumin levels were significantly decreased in hypothyroid group compared to hyperthyroid and euthyroid groups (p < 0.001). In hyperthyroid individuals ischemia modified albumin levels were higher compared to euthyroid ones (p < 0.001). Ischemia modified albumin was negatively correlated with TSH levels (r = -0.473, p < 0.001), and positively correlated with FT4 and FT3 levels (r = 0.496, p < 0.001 and r = 0.275, p = 0.010, respectively). CONCLUSION We suggest that albumin adjusted IMA levels are significantly lower in hypothyroid group than hyperthyroid and euthyroid groups.
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Affiliation(s)
- Mufide Oncel
- Department of Biochemistry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Aysel Kıyıcı
- Department of Biochemistry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Serife Onen
- Department of Internal Medicine, Beyhekim State Hospital, Konya, Turkey
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Sridhar NR, Josyula S. Hypoalbuminemia in hemodialyzed end stage renal disease patients: risk factors and relationships--a 2 year single center study. BMC Nephrol 2013; 14:242. [PMID: 24499139 PMCID: PMC4029609 DOI: 10.1186/1471-2369-14-242] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 10/23/2013] [Indexed: 11/24/2022] Open
Abstract
Background Malnutrition affects 1/3 of hemodialysis patients and associates with a higher risk of morbidity and mortality. Serum albumin is a marker of nutrition and inflammation, and predicts mortality, particularly when <3.8 g/dL. This study was performed to identify risk factors for hypoalbuminemia (<3.8 g/dL) and the particular temporal relationship and strength of association between protein intake (nPCR) and serum albumin when confounding variables are taken into account. Methods Demographic, clinical, and dialysis-related data of 57 ESRD patients on hemodialysis over 24 months in 6 temporal segments were analyzed with serum albumin as a continuous, and categorical outcome (with 3.8 g/dl as cut-off) variable , against 13 potential independent variables [4 demographic factors, 3 nutrition-related, and 5 morbidity-related parameters, and % urea reduction ratio (URR)]. The temporal relationships between albumin and nPCR were analyzed for the concurrent & 3 subsequent months in each temporal segment. Results The impact of nPCR on serum albumin (p < 0.05) was significant but with no discernible temporal relationship. Advancing age, longer vintage, female gender, diabetes mellitus, nPCR, serum phosphate and ferritin had significant correlation with albumin <3.8 g/dl (p < 0.05). Serum phosphate levels correlated positively, and fever, bacteremia, hospital stay and weight loss negatively, with mean serum albumin but did not negate the effect of nPCR. Regression analysis showed that mean albumin associated with nPCR, fever, hospital stay, bacteremia, dialysis vintage, age, sex, and diabetes mellitus; and that an albumin level of <3.8 g/dl associated with age, female sex, diabetes, lower nPCR, and higher ferritin. Conclusion Suggested target albumin levels were not met in elderly, female, and diabetic patients. The association of nPCR with albumin was not nullified by confounding demographic or morbidity-related factors. nPCR had no demonstrable temporal relationship with albumin.
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Affiliation(s)
- Nagaraja Rao Sridhar
- Department of Internal Medicine (Nephrology), Buffalo General Hospital, University at Buffalo, and Buffalo Medical Group, 85 High Street, Buffalo, New York, USA.
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Ischemia-modified albumin, a predictive marker of major adverse cardiovascular events in continuous ambulatory peritoneal dialysis patients. Clin Biochem 2013; 46:1410-3. [PMID: 23796881 DOI: 10.1016/j.clinbiochem.2013.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/08/2013] [Accepted: 06/13/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the efficiency of ischemia-modified albumin (IMA) for predicting major adverse cardiovascular events (MACE) in continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN AND METHODS A prospective observational study was conducted with 120 CAPD patients and 37 healthy volunteers. Demographic and clinical data were collected. The primary end point is the occurrence of MACE. RESULTS A total of 157 participants with a mean age of 43.64 years finally completed this study. The CAPD patients had a significantly high rate of MACE (P=0.001) and high levels of IMA than healthy controls (P<0.001). Compared with CAPD patients with normal levels of IMA, the CAPD patients with high levels of IMA (>85 kU/L) had lower non-MACE survival rate (P<0.001), which indicated that the high IMA CAPD patients may suffer a high rate of MACE. In addition, the high IMA CAPD patients also had a low level of serum albumin (P<0.001) and hemoglobin (P=0.018). The correlation analysis showed that the serum albumin level was the most effective factor influencing IMA (B=-0.967, P<0.001). CONCLUSIONS CAPD patients with high levels of IMA had a high incidence rate of MACE. IMA was a good predictive marker of MACE and might be important in cardiovascular risk stratification of CAPD patients.
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Paustenbach DJ, Tvermoes BE, Unice KM, Finley BL, Kerger BD. A review of the health hazards posed by cobalt. Crit Rev Toxicol 2013; 43:316-62. [DOI: 10.3109/10408444.2013.779633] [Citation(s) in RCA: 155] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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16
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Abstract
In this review we summarize the findings from the literature and our own laboratory on the decreased PON1 activity in renal failure, the mechanisms proposed and the effect of interventions. In addition to profound alterations in lipoproteins, reduced serum PON1 activity has been clearly established in the past decade and could contribute to accelerated development of atherosclerosis in ESRD and in HD. PON1 lactonase activity is lower in ESRD patients. Hemodialysis partially restores PON1 lactonase and the other activities. PON1 activity recovery after dialysis suggests that uremic toxins may play a mechanistic role in PON1 inactivation. Lower PON1 activity in CRF patients is associated with low thiol concentration, high CRP, and is beneficially enhanced with vitamin C and flavonoids. Changes in HDL subclasses, namely lower HDL3 in these patients may also play a role in PON1 lower activity. Future research should focus on: (1) mechanistic studies on causes for low PON1 activity and mass; (2) prospective studies focusing on whether there is an added predictive value in measuring PON1 activity (and PON1 activity in HDL3) in this patient population; (3) intervention studies attempting to increase PON1 activity.
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Albarello K, dos Santos GA, Bochi GV, Sangoi MB, Almeida TC, Paz da Silva JE, Garcia SC, Moresco RN. Ischemia modified albumin and carbonyl protein as potential biomarkers of protein oxidation in hemodialysis. Clin Biochem 2012; 45:450-4. [PMID: 22342921 DOI: 10.1016/j.clinbiochem.2012.01.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 01/20/2012] [Accepted: 01/28/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of HD on ischemia modified albumin (IMA) and protein carbonyl groups in order to investigate the role of IMA as a marker of protein oxidation. DESIGN AND METHODS This study was conducted with 23 chronic hemodialysis patients. The serum IMA levels and protein carbonyl groups were measured immediately before hemodialysis (pre-HD) and after the end of hemodialysis (post-HD). RESULTS IMA concentrations were significantly higher in post-HD than those of the pre-HD and carbonyl protein concentrations were higher in post-HD in comparison with pre-HD. A significant correlation was observed between IMA and carbonyl protein levels. CONCLUSIONS The increase of IMA levels and protein carbonyl groups post-HD could be attributed to the increase of oxidative stress associated with HD, and IMA appears to be an important biomarker for assessing protein oxidation after HD.
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Affiliation(s)
- Kassiano Albarello
- Programa de Pós-Graduação em Hematologia e Hemoterapia, Centro de Ciências Biológicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
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Kanko M, Yavuz S, Duman C, Hosten T, Oner E, Berki T. Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery. J Cardiothorac Surg 2012; 7:3. [PMID: 22221979 PMCID: PMC3398305 DOI: 10.1186/1749-8090-7-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 01/05/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops. METHODS AND RESULTS 30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD) of IMA (0.67677 ± 0.09985) were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894) and postoperative (0.70477 ± 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA. CONCLUSIONS IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.
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Affiliation(s)
- Muhip Kanko
- Kocaeli University, Medical Faculty, Department of Cardiovascular Surgery, Kocaeli, Turkey.
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Şahinli AS, Marakoğlu K, Kiyici A. Evaluation of the levels of oxidative stress factors and ischemia modified albumin in the cord blood of smoker and non-smoker pregnant women. J Matern Fetal Neonatal Med 2011; 25:1064-8. [PMID: 21916812 DOI: 10.3109/14767058.2011.622001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this cross-sectional study was to determine the oxidant and antioxidant status and a novel ischemia marker - ischemia modified albumin - in the cord blood of smoker and non-smoker pregnants. METHODS This study was performed on 30 smoker and 60 non-smoker pregnant women. Malondialdehyde (MDA), vitamin A and E, total antioxidant capacity (TAC) and ischemia modified albumin (IMA) levels and superoxide dismutase activities (SOD) were determined in the cord blood of the contributors. RESULTS In the cord blood of the smoker women compared to the non-smokers; MDA (µmol/L) levels increased (5.17 ± 0.25, 3.60 ± 0.06, p = 0.000), IMA (ABSU) levels increased (0.913 ± 0.02, 0.830 ± 0.01, p = 0.050), SOD (U/ml) activities decreased (8.22 ± 0.14, 8.63 ± 0.14, p = 0.045), Vit A(µg/L) (339.06 ± 17.52, 454.91 ± 16.56, p = 0.000) and Vit E (mg/L) levels decreased (2.8 ± 0.15, 7.58 ± 0.38, p = 0.000) and TAC (Mm Trolox) levels decreased (3.25 ± 0.15, 4.08 ± 0.09, p = 0.000), and these differences were statistically significant. We found moderate and strong positive correlations between smoking status and IMA (r = 0.325, p = 0.002) and smoking status and MDA levels (r = 0.636, p = 0.000). Smoking status presented weak, moderate and strong negative correlations with SOD activities, TAC, Vit A and Vit E levels, respectively (r = -0.237, p = 0.024), (r = -0.420, p = 0.000), (r = -0.443, p=0.000), (r = -0.795, p = 0.000). CONCLUSION It was determined that smoking cigarette during gestation disturbed the balance between the oxidant and antioxidant system and caused oxidative stress. Increased IMA levels in cord blood of smoker pregnants suggests that smoking during pregnancy causes fetal ischemia.
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Affiliation(s)
- Ayla Songül Şahinli
- Selçuk University, Meram Medical Faculty, Department of Family Medicine, Konya, Turkey
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Combinatorial Determination of Ischemia Modified Albumin and Protein Carbonyl in the Diagnosis of NonST-Elevation Myocardial Infarction. Indian J Clin Biochem 2011; 26:389-95. [PMID: 23024476 DOI: 10.1007/s12291-011-0118-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 01/16/2011] [Indexed: 10/18/2022]
Abstract
Ischemia modified albumin (IMA) and Protein Carbonyl (PC) have known as proteins that are modified on the similar basis of oxidative stress induced protein modification and may have diagnostic potential in acute myocardial infarction. This study aims to evaluate the ability of using IMA and PC content to diagnose Non-ST elevation myocardial infarction (NSTEMI) and efficiency of combining these two markers. Serum from NSTEMI and healthy control were determined for serum IMA and PC content. The results showed that both of serum IMA level and PC content in NSTEMI was significantly higher than that of healthy controls. However, the PC content showed greater diagnostic performance than IMA. Combinatorial determination of serum IMA level with PC content level was enhanced test efficiency. In conclusion, our finding demonstrated that IMA and PC content can be used as a diagnostic marker for NSTEMI.
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Role of ischemia-modified albumin in estimating the extent and scope of cardiac ischemia in patients with ST elevation myocardial infarction. Heart Vessels 2011; 26:622-7. [DOI: 10.1007/s00380-010-0114-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 12/17/2010] [Indexed: 10/18/2022]
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