1
|
Romano M, Garcia-Bournissen F, Piskin D, Rodoplu U, Piskin L, Elzagallaai AA, Tuncer T, Sezer S, Ucuncuoglu D, Honca T, Poddighe D, Yavuz I, Stenvinkel P, Yilmaz MI, Demirkaya E. Anti-Inflammatory, Antioxidant, and Anti-Atherosclerotic Effects of Natural Supplements on Patients with FMF-Related AA Amyloidosis: A Non-Randomized 24-Week Open-Label Interventional Study. Life (Basel) 2022; 12:life12060896. [PMID: 35743929 PMCID: PMC9228597 DOI: 10.3390/life12060896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to evaluate the effect of a combination of natural products on parameters related to inflammation, endothelial dysfunction, and oxidative stress in a cohort of familial Mediterranean fever (FMF) patients with Serum Amyloid A amyloidosis, in a non-randomized, 24-week open-label interventional study. Morinda citrifolia (anti-atherosclerotic-AAL), omega-3 (anti-inflammatory-AIC), and extract with Alaskan blueberry (antioxidant-AOL) were given to patients with FMF-related biopsy-proven AA amyloidosis. Patients were >18 years and had proteinuria (>3500 mg/day) but a normal estimated glomerular filtration rate (eGFR). Arterial flow-mediated dilatation (FMD), carotid intima media thickness (CIMT), and serum biomarkers asymmetric dimethylarginine (ADMA), high sensitivity C-reactive protein (hs-CRP), pentraxin (PTX3), malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), and glutathione peroxidase (GSH-Px) were studied at baseline and after 24 weeks of treatment. A total of 67 FMF-related amyloidosis patients (52 male (77.6%); median age 36 years (range 21−66)) were enrolled. At the end of a 24-week treatment period with AAL, AIC, and AOL combination therapy, ADMA, MDA, PTX3, hsCRP, cholesterol, and proteinuria were significantly decreased compared to baseline, while CuZn-SOD, GSH-Px, and FMD levels were significantly increased. Changes in inflammatory markers PTX3, and hsCRP were negatively correlated with FMD change, and positively correlated with decreases in proteinuria, ADMA, MDA, cholesterol, and CIMT. Treatment with AAL, AIC and AOL combination for 24 weeks were significantly associated with reduction in inflammatory markers, improved endothelial functions, and oxidative state. Efficient control of these three mechanisms can have long term cardiovascular and renal benefits for patients with AA amyloidosis.
Collapse
Affiliation(s)
- Micol Romano
- Department of Paediatrics, Division of Paediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (E.D.)
- Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
| | - Facundo Garcia-Bournissen
- Department of Paediatrics, Division of Paediatric Clinical Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
| | - David Piskin
- Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Ulkumen Rodoplu
- Emergency Medicine Association of Turkey of All, 35220 Izmir, Turkey;
| | - Lizzy Piskin
- Robarts Research Institute, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Abdelbaset A. Elzagallaai
- Schulich School of Medicine & Dentistry, Physiology and Pharmacology, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Tunc Tuncer
- Unit of Biochemistry, Epigenetic Health Solutions, 06810 Ankara, Turkey;
| | - Siren Sezer
- Division of Nephrology, Faculty of Medicine, Atilim University, 06830 Ankara, Turkey;
| | - Didar Ucuncuoglu
- Department of Food Engineering, Faculty of Engineering, Cankiri Karatekin University, 18100 Cankiri, Turkey;
| | - Tevfik Honca
- Unit of Biochemistry, Gur Life Hospital, 26320 Eskisehir, Turkey;
| | - Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan;
- Clinical Academic Department of Pediatrics, National Research Center of Maternal and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan
| | - Izzet Yavuz
- Department of Nephrology, Lokman Hekim University, 06510 Ankara, Turkey;
| | - Peter Stenvinkel
- Department of Renal Medicine M99, Karolinska Institute, Karolinska University Hospital, 17164 Stockholm, Sweden;
| | - Mahmut Ilker Yilmaz
- Unit of Nephrology, Center for Epigenetic Health Solutions, 06810 Ankara, Turkey
- Correspondence:
| | - Erkan Demirkaya
- Department of Paediatrics, Division of Paediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (E.D.)
- Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
| |
Collapse
|
2
|
|
3
|
Dinç G, Fentoğlu Ö, Doğru A, İlhan İ, Kırzıoğlu FY, Orhan H. The evaluation of salivary oxidative stress in patients with familial Mediterranean fever and chronic periodontitis. J Periodontol 2018; 89:1112-1120. [PMID: 29761911 DOI: 10.1002/jper.17-0638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is an inherent autoinflammatory disease and have a high prevalence in Mediterranean countries. The aim of this study was to evaluate salivary levels of oxidative stress parameters in patients with FMF and chronic periodontitis. METHODS The study population consists of 81 patients with FMF and 85 systemically healthy controls. The test and control groups were classified as chronic periodontitis and periodontally healthy [FMF-periodontitis (n = 37); FMF-periodontally healthy (n = 44); systemically healthy-periodontitis (n = 37); systemically and periodontally healthy (n = 48]. Total salivary samples were collected. Clinical periodontal parameters including plaque index, gingival index (GI), probing depth (PD), the percentage of bleeding on probing (BOP%), and clinical attachment level (CAL), were measured. Salivary total antioxidant status (TAS), total oxidant status (TOS), 8-hydroxydeoxyguanosine (8-OHdG), malondialdehyde (MDA), and oxidative stress index (OSI) were evaluated. RESULTS The FMF-periodontitis group had significantly higher levels of 8-OHdG, MDA, and OSI than that of the FMF-periodontally healthy group. In the FMF-periodontitis group, PD, 8-OHdG, MDA, and OSI levels were significantly higher than in the systemically healthy-periodontitis group (P = 0.035, P = 0.000, P = 0.000, and P = 0.000, respectively). 8-OHdG values were significantly correlated with BOP% and GI, and TOS values were significantly correlated with PD and CAL in the FMF-periodontitis group. CONCLUSIONS In the presence of FMF and chronic periodontitis, there were increased salivary levels of oxidative stress. Thus, oxidative stress could be an important inflammatory mechanism in the FMF and chronic periodontitis. Further studies need to clarify the oxidative mechanisms of FMF and chronic periodontitis.
Collapse
Affiliation(s)
- Gözde Dinç
- Department of Periodontology, Faculty of Dentistry, University of Süleyman Demirel, Isparta, Turkey
| | - Özlem Fentoğlu
- Department of Periodontology, Faculty of Dentistry, University of Süleyman Demirel, Isparta, Turkey
| | - Atalay Doğru
- Department of Internal Medicine, Division of Rheumatology, University of Süleyman Demirel, Isparta, Turkey
| | - İlter İlhan
- Department of Medical Biochemistry, Faculty of Medicine, University of Süleyman Demirel, Isparta, Turkey
| | - F Yeşim Kırzıoğlu
- Department of Periodontology, Faculty of Dentistry, University of Süleyman Demirel, Isparta, Turkey
| | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, University of Süleyman Demirel, Isparta, Turkey
| |
Collapse
|
4
|
Milenković J, Vojinović J, Debeljak M, Toplak N, Lazarević D, Avčin T, Jevtović-Stoimenov T, Pavlović D, Bojanić V, Milojković M, Kocić G, Veljković A. Distribution of MEFV gene mutations and R202Q polymorphism in the Serbian population and their influence on oxidative stress and clinical manifestations of inflammation. Pediatr Rheumatol Online J 2016; 14:39. [PMID: 27364639 PMCID: PMC4929733 DOI: 10.1186/s12969-016-0097-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/02/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The Mediterranean fever (MEFV) gene codes for protein pyrin, one of the regulators of inflammasome activity in innate immune cells. Mutations in this gene are considered the primary cause of Familial Mediterranean fever, but are also found in other monogenic and multifactorial autoinflammatory diseases. The aim of the study was to determine if healthy carriers of MEFV gene mutations and R202Q polymorphism have clinical manifestations of inflammation and impaired oxidative stress parameters. METHODS One hundred DNA samples from healthy volunteers (13.3 ± 8.87 years of age (mean ± SD); range 2-35) were sequenced by ABI PRISM 310 automated sequencer (PE Applied Biosystems, Norwalk, USA). The Eurofever questionnaire was used to collect retrospectively medical history data. Oxidative stress was determined by measuring spectrophotometrically thiobarbituric acid reactive substances (TBARS) in plasma and erythrocytes, as well as advanced oxidation protein products in plasma. Superoxide dismutase (SOD) activity was determined by McCord and Fridovich method in plasma and erythrocytes, while the catalase erythrocyte activity was assessed using a catalase ELISA kit. RESULTS We found heterozygous carriers of K695R/N mutations in 5 %, E148Q/N mutations in 6 %, R202Q homozygous polymorphism in 10 % and heterozygous R202Q alterations in 45 % of healthy volunteers. The MEFV mutation carriers and R202Q polymorphism homozygotes reported significantly more often recurrent febrile episodes (p = 0.009), diffuse abdominal pain (p = 0.025), and malaise (p = 0.012) compared to non-carriers. Erythrocyte TBARS levels and plasma SOD activity were higher in persons with MEFV mutations and R202Q/R202Q (p = 0.03 and p = 0.049, respectively). CONCLUSIONS Healthy individuals may bear E148Q and K695R MEFV gene mutations, as well as R202Q polymorphism in homozygous state. The determined gene alterations contribute to a subtle oxidative stress and may be associated with more frequent episodes of fever and unspecific inflammatory manifestations. An incomplete penetrance or variable expressivity of R202Q in populations of different ethnicity could influence the expression of autoinflammatory diseases phenotype.
Collapse
Affiliation(s)
- Jelena Milenković
- Institute of Pathophysiology, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000, Niš, Serbia.
| | - Jelena Vojinović
- Department of Pediatric Rheumatology, Clinical Center, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Maruša Debeljak
- Unit for Special Laboratory Diagnostics, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | - Nataša Toplak
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center; Faculty of Medicine, University of Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | - Dragana Lazarević
- Department of Pediatric Rheumatology, Clinical Center, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Tadej Avčin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center; Faculty of Medicine, University of Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | - Tatjana Jevtović-Stoimenov
- Institute of Biochemistry, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Dušica Pavlović
- Institute of Biochemistry, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Vladmila Bojanić
- Institute of Pathophysiology, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Maja Milojković
- Institute of Pathophysiology, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Gordana Kocić
- Institute of Biochemistry, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| | - Andrej Veljković
- Institute of Biochemistry, Faculty of Medicine, University of Niš, Bul. Zorana Đinđića 81, 18000 Niš, Serbia
| |
Collapse
|
5
|
Yucel A, Sanhal CY, Daglar K, Kara O, Uygur D, Erel O. Thiol/disulphide homeostasis in pregnant women with Familial Mediterranean fever. Redox Rep 2016; 21:287-91. [PMID: 27077456 DOI: 10.1080/13510002.2016.1168590] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To investigate the presence of oxidative stress (OS) in pregnant women with Familial Mediterranean fever (FMF) in the first trimester by evaluating thiol/disulphide homeostasis. STUDY DESIGN A total of 31 pregnant women with a diagnosis of FMF, between 11(0) and 13(6) weeks of gestation, were compared with 51 healthy pregnant controls at the same gestational weeks. A recently defined method was used to measure plasma native thiol, total thiol and disulphide levels. RESULTS There were no differences between groups in terms of maternal age, body mass index and numbers of gravida and parity. Antenatal complications (45.2% vs. 9.8%, P = 0.001) and primary caesarean section (22.6% vs. 5.9%, P = 0.037) were higher in the FMF group. Pregnant women with FMF had significantly lower first trimester serum levels of native thiol (297.5 μmol/l (153.2-441.8) vs. 366.1 μmol/l (288.7-432.4), P = 0.000), total thiol (327.2 μmol/l (171.0-471.0) vs. 389.9 μmol/l (317.1-449.8), P = 0.000) and higher levels of disulphide (14.2 ± 4.5 μmol/l vs. 12.4 ± 3.4 μmol/l, P = 0.045). No differences were found in these parameters among FMF patients with and without antenatal complications. CONCLUSIONS The main outcome demonstrates a relation between OS and pregnant women with FMF in the first trimester of gestation. OS in the first trimester may be a major aetiological factor of unfavourable pregancy outcomes in this group of patients.
Collapse
Affiliation(s)
- Aykan Yucel
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Cem Yasar Sanhal
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Korkut Daglar
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Ozgur Kara
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Dilek Uygur
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Ozcan Erel
- b Department of Clinical Biochemistry, Faculty of Medicine , Yildirim Beyazit University , Ankara , Turkey
| |
Collapse
|
6
|
Manukyan G, Aminov R, Hakobyan G, Davtyan T. Accelerated apoptosis of neutrophils in familial mediterranean Fever. Front Immunol 2015; 6:239. [PMID: 26042122 PMCID: PMC4435041 DOI: 10.3389/fimmu.2015.00239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/04/2015] [Indexed: 12/11/2022] Open
Abstract
The causative mutations for familial Mediterranean fever (FMF) are located in the MEFV gene, which encodes pyrin. Pyrin modulates the susceptibility to apoptosis via its PYD domain, but how the mutated versions of pyrin affect apoptotic processes are poorly understood. Spontaneous and induced rates of systemic neutrophil apoptosis as well as the levels of proteins involved in apoptosis were investigated ex vivo in patients with FMF using flow cytometry and RT-qPCR. The freshly collected neutrophils from the patients in FMF remission displayed a significantly larger number of cells spontaneously entering apoptosis compared to control (6.27 ± 2.14 vs. 1.69 ± 0.18%). This elevated ratio was retained after 24 h incubation of neutrophils in the growth medium (32.4 ± 7.41 vs. 7.65 ± 1.32%). Correspondingly, the mRNA level for caspase-3 was also significantly increased under these conditions. In response to the inducing agents, the neutrophils from FMF patients also displayed significantly elevated apoptotic rates compared to control. The elevated rates, however, can be largely explained by the higher basal ratio of apoptotic cells in the former group. Monitoring of several proteins involved in apoptosis has not revealed any conventional mechanisms contributing to the enhanced apoptotic rate of neutrophils in FMF. Although the exact molecular mechanisms of accelerated neutrophil apoptosis in FMF remain unknown, it may provide a protection against excessive inflammation and tissue damage due to a massive infiltration of neutrophils in the acute period of the disease.
Collapse
Affiliation(s)
- Gayane Manukyan
- Group of Molecular and Cellular Immunology, Institute of Molecular Biology, National Academy of Sciences , Yerevan , Armenia
| | - Rustam Aminov
- National Veterinary Institute, Technical University of Denmark , Copenhagen , Denmark
| | - Gagik Hakobyan
- Department of Internal Medicine, Yerevan State Medical University , Yerevan , Armenia
| | - Tigran Davtyan
- Analytical Laboratory Branch, Scientific Centre of Drug and Medical Technology Expertise JSC , Yerevan , Armenia
| |
Collapse
|
7
|
Bostanci V, Toker H, Senel S, Ozdemir H, Aydin H. Effect of Chronic Periodontitis on Serum and Gingival Crevicular Fluid Oxidant and Antioxidant Status in Patients With Familial Mediterranean Fever Before and After Periodontal Treatment. J Periodontol 2014; 85:706-12. [DOI: 10.1902/jop.2013.130230] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
8
|
Guzel S, Andican G, Seven A, Aslan M, Bolayirli M, Guzel EC, Hamuryudan V. Acute phase response and oxidative stress status in familial Mediterranean fever (FMF). Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0517-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
9
|
Savran Y, Sari I, Kozaci DL, Gunay N, Onen F, Akar S. Increased levels of macrophage migration inhibitory factor in patients with familial mediterranean Fever. Int J Med Sci 2013; 10:836-9. [PMID: 23794947 PMCID: PMC3689875 DOI: 10.7150/ijms.6116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 04/16/2013] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To determine the level of macrophage migration inhibitory factor (MIF), its relationship with Mediterranean fever (MEFV) gene mutations and oxidative stress in familial Mediterranean fever (FMF). METHODS Fifty one unrelated attack free FMF patients (24 M and 27 F, 32.8±8.7 years) and 30 healthy controls (16 M and 14 F, 32.7±7 years) were included in the study. Serum MIF, total oxidant status (TOS) and total anti-oxidant status (TAS) were studied. RESULTS Age, sex distribution, anthropometrical indices, smoking status, serum lipids and TAS concentrations were similar between the patients and controls. However; erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), MIF, and TOS were significantly higher in the patients' group compared with healthy subjects. MIF, TOS and TAS levels were not different between patients with or without M694V mutations. CONCLUSION We found increased concentrations of MIF in patients with FMF. Increased MIF levels were significantly correlated with oxidative stress and in regression analysis MIF concentrations were independent from the inflammatory activity as assessed by ESR and CRP. M694V mutations seem no effect on MIF and oxidative stress.
Collapse
Affiliation(s)
- Yusuf Savran
- Dokuz Eylul University School of Medicine, Department of Internal Medicine, Izmir, Turkey
| | | | | | | | | | | |
Collapse
|
10
|
Genetic analysis of C5a receptors in neutrophils from patients with familial Mediterranean fever. Mol Biol Rep 2011; 39:5503-10. [PMID: 22187344 DOI: 10.1007/s11033-011-1353-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 12/12/2011] [Indexed: 01/09/2023]
Abstract
Familial Mediterranean fever (FMF) is an autoinflammatory disease, characterized by MEFV gene mutations and self-limited recurrent episodes of fever and localized serositis. Complement system is a key regulator of the inflammatory process. The aim of this study was to investigate the genetic alterations and mRNA expression pattern of C5aR and C5L2 genes in neutrophils from attack-free FMF patients. No mutations were observed in the two receptors' genes, while the genetic alteration observed in the C5aR1 gene was identified as N279 K polymorphic variant. Furthermore, lower mRNA expression of C5L2 gene was observed in neutrophils from FMF patients compared to control subjects. The binding capacity of rhC5a and the ability to produce reactive oxygen species was similar in neutrophils from healthy subjects and FMF patients and independent of the presence of N279 K polymorphism or mRNA expression of C5L2.
Collapse
|
11
|
Guzel S, Andican G, Seven A, Aslan M, Bolayirli M, Guzel EC, Hamuryudan V. Acute phase response and oxidative stress status in familial Mediterranean fever (FMF). Mod Rheumatol 2011; 22:431-7. [PMID: 21947799 DOI: 10.1007/s10165-011-0517-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 08/16/2011] [Indexed: 11/26/2022]
Abstract
We aimed to determine acute phase response (APR) and oxidative stress in patients with familial Mediterranean fever (FMF) and compare these characteristics with those in healthy controls; 20 patients with FMF and 15 healthy controls were enrolled in the study. The erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), fibrinogen, and leukocyte levels were determined as markers of APR. Thiobarbituric acid reactive substances (TBARS), conjugated diene, and lipid hydroperoxide levels were measured as markers of lipid peroxidation. Carbonyl group and thiol (T-SH) levels were analyzed to determine the oxidative damage to proteins, and 8-hydroxy-2-deoxyguanosine (8-OHdG) was measured to reflect DNA oxidation. The erythrocyte glutathione (GSH) level, and glutathione peroxidase (GSH-Px), CuZn superoxide dismutase (CuZn SOD), and catalase activities were measured as markers of antioxidant status. Conjugated diene (p < 0.001) and carbonyl group (p < 0.05) levels were significantly higher and GSH-Px activity (p < 0.01) was significantly lower in FMF patients compared with controls. FMF patients in the attack period (n = 8) had significantly higher CRP, ESR, fibrinogen, and leukocyte levels (p < 0.001) than patients in the attack-free period (n = 12). The T-SH level (p < 0.05) was significantly higher and CuZn SOD activity was significantly lower (p < 0.05) in FMF patients in the attack period. The findings revealed upregulated APR during the attack period in FMF patients and enhanced oxidative stress in the FMF patients as compared to controls.
Collapse
Affiliation(s)
- Savas Guzel
- Department of Biochemistry, Medical Faculty, Namik Kemal University, Tekirdag, Turkey.
| | | | | | | | | | | | | |
Collapse
|
12
|
Ediz L, Ozkol H, Tekeoglu I, Tuluce Y, Gulcu E, Koyuncu I. Increased oxidative stress in patients with familial Mediterranean fever during attack period. Afr Health Sci 2011; 11 Suppl 1:S6-13. [PMID: 22135646 PMCID: PMC3220131 DOI: 10.4314/ahs.v11i3.70063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES We aimed to investigate the status of oxidant and antioxidants during attack period (AP) and attack free periods (AFP) in Familial Mediterranean fever (FMF) patients. METHODS Measured the levels of malondialdehyde (MDA), protein carbonyl (PC), glutathione (GSH) and antioxidant vitamins (A,C and E) as well as the activities of catalase (CAT) and glutathione peroxidase (GSH-Px) in serum and whole blood of FMF patients in FMF-AP and FMF-AFP. RESULTS Levels of MDA and PC were found significantly higher (p <0.05) both in serum and whole blood of FMF-AP group compared with other groups. The CAT and GSH-Px activities in FMF-AP group were found markedly lower (p <0.05) comparing to HC group. However, there were no statistically significant differences between the groups in terms of antioxidant vitamin levels. CONCLUSIONS Our study demonstrated increased oxidative stress in patients with FMF during AP. Investigations are needed to establish the effect of antioxidant supplementation on FMF attack frequency and severity. We also suggest that these increased MDA and PC levels and decreased antioxidants may be used as supportive markers to differentiate AP from AFP. These conclusions need to be validated in further multicenter studies with high number of FMF patients.
Collapse
Affiliation(s)
- L Ediz
- Yuzuncu Yil University, Medical Faculty, Physical Medicine-Rehabilitation and Rheumatology Department, Van, Turkey.
| | | | | | | | | | | |
Collapse
|
13
|
Chae JJ, Aksentijevich I, Kastner DL. Advances in the understanding of familial Mediterranean fever and possibilities for targeted therapy. Br J Haematol 2009; 146:467-78. [PMID: 19466978 DOI: 10.1111/j.1365-2141.2009.07733.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Familial Mediterranean fever (FMF) is a systemic autoinflammatory disorder characterized by seemingly unprovoked recurrent episodes of fever and serosal, synovial, or cutaneous inflammation. FMF is caused by recessively inherited mutations in MEFV, which encodes pyrin, and most of the mutations are present in the C-terminal end of the protein encoding B30.2 domain. The FMF carrier frequencies are extremely high in several eastern Mediterranean populations. Pyrin is expressed in granulocytes, monocytes, dendritic cells, and synovial fibroblasts. Pyrin regulates caspase-1 activation and consequently interleukin-1beta production through the interactions of its N-terminal PYRIN domain and C-terminal B30.2 domain with an adaptor protein, apoptosis-associated speck-like protein with a caspase-recruitment domain (ASC) and caspase-1 respectively. Pyrin is cleaved by caspase-1 and the cleaved N-terminal fragment translocates to nucleus and enhances ASC-independent nuclear factor (NF)-kappaB activation through interactions with p65 NF-kappaB and IkappaB-alpha. In addition to the regulatory role of pyrin for caspase-1, the cleavage of pyrin provides an important clue not only in understanding the molecular pathogenesis of FMF but also in developing new therapeutic targets for FMF.
Collapse
Affiliation(s)
- Jae J Chae
- Laboratory of Clinical Investigation, National Institutes of Arthritis and Musculoskeletal and Skin Diseases, Genetics and Genomics Branch, Bethesda, MD 20892-1849, USA.
| | | | | |
Collapse
|
14
|
Kirkali G, Tunca M, Genc S, Jaruga P, Dizdaroglu M. Oxidative DNA damage in polymorphonuclear leukocytes of patients with familial Mediterranean fever. Free Radic Biol Med 2008; 44:386-93. [PMID: 17967429 DOI: 10.1016/j.freeradbiomed.2007.09.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 09/09/2007] [Accepted: 09/29/2007] [Indexed: 01/22/2023]
Abstract
Familial Mediterranean fever (FMF) is an autosomal recessively inherited disorder characterized by recurrent, inflammatory self-limited episodes of fever and other symptoms. This disease is caused by more than 25 mutations in the gene MEFV. During fever attacks, there is a substantial influx of polymorphonuclear leukocytes into the affected tissues. Attack-free periods are accompanied by the up-regulation of neutrophil and monocyte phagocytic activity and oxidative burst. These facts led us to hypothesize that oxidative damage by free radicals to DNA may accumulate in FMF patients. To test this hypothesis, we investigated oxidative DNA damage in polymorphonuclear leukocytes of FMF patients during the attack-free period in comparison with FMF-free control individuals. DNA was isolated from polymorphonuclear leukocytes of 17 FMF patients and 10 control individuals. DNA samples were analyzed by liquid chromatography/mass spectrometry and gas chromatography/mass spectrometry to measure the levels of various typical oxidatively induced products of DNA. We show, for the first time, that FMF patients accumulate statistically significant levels of these lesions in their DNA when compared to FMF-free control individuals. This work suggests that the persistent oxidative stress with excess production of free radicals in FMF patients may lead to accumulation of oxidative DNA damage. Defective DNA repair may also contribute to this phenomenon, perhaps due to mutations in the MEFV gene. The accumulation of mutagenic and cytotoxic DNA lesions may contribute to increased mutations and apoptosis in FMF patients, thus to worsening of the disease and well-being of the patients. Future research should deal with prevention of oxidative DNA damage and apoptosis in FMF patients, and also the elucidation of a possible role of DNA repair in this disease.
Collapse
Affiliation(s)
- Güldal Kirkali
- Chemical Science and Technology Laboratory, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA.
| | | | | | | | | |
Collapse
|
15
|
Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25-1999. A 16-year-old boy with recurrent abdominal pain. N Engl J Med 1999; 341:593-9. [PMID: 10451466 DOI: 10.1056/nejm199908193410808] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|