1
|
Djordjevic K, Milojevic Samanovic A, Veselinovic M, Zivkovic V, Mikhaylovsky V, Mikerova M, Reshetnikov V, Jakovljevic V, Nikolic Turnic T. Oxidative Stress Mediated Therapy in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Antioxidants (Basel) 2023; 12:1938. [PMID: 38001790 PMCID: PMC10669381 DOI: 10.3390/antiox12111938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE The aim of this meta-analysis is to explore all the available literature to obtain updated data about the potential use of antioxidants in the treatment of rheumatoid arthritis (RA) and its ability to reduce disease progression and cardiovascular risk. METHODS This systematic review and meta-analysis was performed strictly in accordance with the PRISMA guidelines. English and Chinese databases were searched with a retrieval time up to March 2023. These databases included the PubMed, Embase, Medline Complete, Web of Sciences and Cochrane Collaboration, Wanfang, China National Knowledge Infrastructure, and VIP databases. This literature search was formulated by the two researchers independently. The search strategy consists of reading, collecting the literature, and conducting the preliminary screening. After that, they provide the final selection of the literature according to the inclusion criteria and data extraction. Also, for all studies, the risk bias was assessed to evaluate the quality of the included references. The content of the risk assessment of bias included the following criteria: random allocation method, allocation plan hiding, blind method, completeness of result data, and selectivity of reporting of results, as well as other biases. The main outcomes were clinical efficiency of antioxidant therapy (C-reactive protein, DAS28 score, HAQ, Number of tender joints, etc.) and oxidative stress indicators (catalase, superoxide dismutase, or total antioxidant capacity). RESULTS We observed, in most of the studies, the small or moderate effects of antioxidant treatment. The mean effect size is 0.525, and that means that moderate effects were observed in 30 selected RCTs. Also, this effect is confirmed in the 1652 patients with RA with the mean confidence interval of 0.276 (lower limit) and 0.983 (upper limit). Cohen coefficient was calculated at 0.05. CONCLUSION The existing evidence is that antioxidants can reduce systemic and local oxidative stress and can reduce damage as the main agent involved in autoimmune diseases such as rheumatoid arthritis.
Collapse
Affiliation(s)
- Katarina Djordjevic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia;
| | - Andjela Milojevic Samanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia;
| | - Mirjana Veselinovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia;
- Clinic for Rheumatology and Allergology, University Clinical Center, 34000 Kragujevac, Serbia
| | - Vladimir Zivkovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia; (V.Z.); (V.J.)
- Department of Pharmacology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Victor Mikhaylovsky
- N.A. Semashko Public Health and Healthcare Department, F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (V.M.); (M.M.); (V.R.)
| | - Maria Mikerova
- N.A. Semashko Public Health and Healthcare Department, F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (V.M.); (M.M.); (V.R.)
| | - Vladimir Reshetnikov
- N.A. Semashko Public Health and Healthcare Department, F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (V.M.); (M.M.); (V.R.)
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia; (V.Z.); (V.J.)
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Tamara Nikolic Turnic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia;
- N.A. Semashko Public Health and Healthcare Department, F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia; (V.M.); (M.M.); (V.R.)
| |
Collapse
|
2
|
Rezaei Zonooz S, Hasani M, Morvaridzadeh M, Beatriz Pizarro A, Heydari H, Yosaee S, Rezamand G, Heshmati J. Effect of alpha-lipoic acid on oxidative stress parameters: A systematic review and meta-analysis. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
|
3
|
The Efficacy of Antioxidative Stress Therapy on Oxidative Stress Levels in Rheumatoid Arthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:3302886. [PMID: 34659630 PMCID: PMC8517629 DOI: 10.1155/2021/3302886] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/04/2021] [Indexed: 12/29/2022]
Abstract
Objective To explore the efficacy of antioxidative stress therapy on oxidative stress levels in rheumatoid arthritis (RA) by a systematic review and meta-analysis of randomized controlled trials. Methods Chinese and English databases such as PubMed, Embase, China National Knowledge Infrastructure (CNKI), and China Biomedical Literature were searched, mainly searching for clinical randomized controlled trials of antioxidant therapy for rheumatoid arthritis. The search time is from the establishment of the database to July 2021. Two researchers independently carried out literature search, screening, and data extraction. The bias risk tool provided by the Cochrane Collaboration was used to evaluate the bias risk of all the included literature, and the RevMan 5.3 software was used for meta-analysis. Results A total of 24 RCTs (28 records) and 1277 participants were included. The time span of randomized controlled trials (RCTs) is from 1986 to 2020. These RCTs involve 14 types of antioxidants or antioxidant therapies, and these therapies have varying degrees of improvement on oxidative stress in RA patients. The summary results showed that the MDA in the experiment group is lower (SMD -0.82, 95% CI -1.35 to -0.28, P = 0.003). The difference of TAC, SOD, NO, GPx, CAT, and GSH between two groups was of no statistical significance (TAC (SMD 0.27, 95% CI -0.21 to 0.75, P = 0.27), SOD (SMD 0.12, 95% CI -0.16 to 0.40, P = 0.41), NO (SMD -2.03, 95% CI -4.22 to 0.16, P = 0.07), GPx (SMD 0.24, 95% CI -0.07 to 0.54, P = 0.13), CAT (SMD 2.95, 95% CI -2.6 to 8.51, P = 0.30), and GSH (SMD 2.46, 95% CI -0.06 to 4.98, P = 0.06)). For adverse events, the summary results showed that the difference was of no statistical significance (RR 1.16, 95% CI 0.79 to 1.71, P = 0.45). In addition, antioxidant therapy has also shown improvement in clinical efficacy indexes (number of tender joints, number of swollen joints, DAS28, VAS, and HAQ) and inflammation indexes (ESR, CRP, TNF-α, and IL6) for RA patients. Conclusion The existing evidence shows potential benefits, mainly in reducing MDA and increasing TAC and GSH in some subgroups. However, more large samples and higher quality RCTs are needed to provide high-quality evidence, so as to provide more clinical reference information for the antioxidant treatment of RA.
Collapse
|
4
|
Moazen M, Mazloom Z, Tanideh N, Dabbaghmanesh MH, Rahmdel S, Azarpira N, Fararouei M. Osteoprotective effects of kefir fortified with omega-3 and vitamin C in ovariectomized rats. INT J VITAM NUTR RES 2021:1-10. [PMID: 34162225 DOI: 10.1024/0300-9831/a000718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Nutritional interventions can be valuable for the prevention of postmenopausal osteoporosis. This study aimed to investigate the effects of kefir fortified with omega-3 and vitamin C on the bone and uterus parameters of ovariectomized rats. Seventy-seven female Sprague-Dawley rats were ovariectomized or sham-operated. The ovariectomized rats were assigned to six groups and received 1 ml/day of distilled water (OVX group), milk, kefir, kefir fortified with omega-3 (kefir+ω3), kefir fortified with vitamin C (kefir+vit-C) or kefir fortified with omega-3 and vitamin C (kefir+ω3+vit-C) for 12 weeks. The sham group also received 1ml/day of distilled water. Subsequently, bone mineral content (BMC) and bone mineral density (BMD) of various bones were assessed. Femurs and uteri were harvested for bone ash analysis and histopathological examinations, respectively. Sera were analyzed for carboxy-terminal cross-linked telopeptide of type 1 collagen, procollagen type 1 amino-terminal propeptide, calcium, phosphorous, tumor necrosis factor-α (TNF-α) and total antioxidant capacity levels. Ovariectomy resulted in significant reduction in bone density (P<0.05). Kefir+ω3+vit-C significantly improved BMC of lumbar spine (0.699±0.027 g compared with 0.580±0.018 in the OVX group), and kefir, kefir+vit-C and kefir+ω3+vit-C significantly increased BMD of tibia (0.118±0.003 g/cm2, 0.119±0.001 and 0.120±0.004 compared with 0.102±0.005 in the OVX group). Moreover, ovariectomy markedly elevated TNF-α level, which was significantly reversed by kefir+ω3+vit-C. Significant atrophy of the uterus was observed following ovariectomy, although the uterus parameters did not change by any of the interventions. In conclusion, kefir fortified with omega-3 and vitamin C may have protective effects against bone loss through suppressing inflammation.
Collapse
Affiliation(s)
- Mahsa Moazen
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Mazloom
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Tanideh
- Stem Cells Technology Research Center, Department of Pharmacology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Samane Rahmdel
- Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Azarpira
- Department of Pathology, Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
5
|
Sharifi-Zahabi E, Abdollahzad H, Mostafa Nachvak S, Moloudi J, Golpayegani MR, Asiaei S, Rezavand L, Iraji Z, Jamshidi K. Effects of alpha lipoic acid on iron overload, lipid profile and oxidative stress indices in β-thalassemia major patients: A cross-over randomised controlled clinical trial. Int J Clin Pract 2021; 75:e14062. [PMID: 33527721 DOI: 10.1111/ijcp.14062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS β-Thalassemia major (β-TM) is associated with iron overload, abnormal lipid levels and oxidative stress. Alpha lipoic acid (ALA) showed anti-oxidant and iron chelating properties, but its effect in β-TM patients is unclear. We investigated the effects of ALA on iron levels, lipid profile and oxidative stress. METHODS In this cross-over randomised clinical trial, 26 β-TM patients were assigned to receive 600 mg/d ALA or placebo (corn starch), for 8 weeks with a 21-days washout period. Serum ferritin, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C, total antioxidant capacity, malondialdehyde (MDA) and MDA/LDL-C were assessed at baseline and the end of each intervention phase. RESULTS Twenty-two patients completed the study. Serum ferritin (P = .004), MDA (P = .025) and MDA/LDL-C ratio (P =.002) were decreased and HDL-C (P =.035) increased significantly during ALA consumption. In comparison with placebo, ALA decreased the serum ferritin significantly (P = .02). Also, the changes in serum ferritin between ALA and placebo (-123.1 ± 40.0 vs -34.3 ± 21.0, P =.03) was significant in women subgroup. ALA had no significant effects on the other biomarkers. CONCLUSION The results of this study indicated that supplementation with 600 mg/d ALA may decrease serum ferritin in β-TM. Further studies are needed to confirm the findings.
Collapse
Affiliation(s)
- Elham Sharifi-Zahabi
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Abdollahzad
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Mostafa Nachvak
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jalal Moloudi
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Reza Golpayegani
- Department of Pediatrics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahar Asiaei
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Laya Rezavand
- Imam Khomeini Comprehensive Health Services Center, Health Deputy, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zeynab Iraji
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khadijeh Jamshidi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
6
|
Petridou AI, Zagora ET, Petridis P, Korres GS, Gazouli M, Xenelis I, Kyrodimos E, Kontothanasi G, Kaliora AC. The Effect of Antioxidant Supplementation in Patients with Tinnitus and Normal Hearing or Hearing Loss: A Randomized, Double-Blind, Placebo Controlled Trial. Nutrients 2019; 11:E3037. [PMID: 31842394 PMCID: PMC6950042 DOI: 10.3390/nu11123037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/27/2019] [Accepted: 12/03/2019] [Indexed: 01/08/2023] Open
Abstract
Tinnitus is the perception of sound in the absence of any external stimulus. Oxidative stress is possibly involved in its pathogenesis and a variety of antioxidant compounds have been studied as potential treatment approaches. The objective of the present study was to assess the effects of antioxidant supplementation in tinnitus patients. This is a randomized, double-blind, placebo-controlled clinical trial. Patients (N = 70) were randomly allocated to antioxidant supplementation (N = 35) or to placebo (N = 35) for a total of 3 months. Demographic, anthropometric, clinical, and nutritional data were collected. Serum total antioxidant capacity (TAC), oxidized LDL (oxLDL), and superoxide dismutase (SOD), tinnitus loudness, frequency, and minimum masking level (MML), and scores in Tinnitus Handicap Inventory questionnaire (THI), Tinnitus Functional Index (TFI), and Visual Analogue Scale (VAS) were evaluated at baseline and follow-up. Tinnitus loudness and MML significantly decreased from baseline to post measure (p < 0.001) only in the antioxidant group, the overall change being significantly different between the two groups post-intervention (p < 0.001). THI and VAS decreased only in the antioxidant group. Differences in changes in serum TAC, SOD, and oxLDL post-intervention were insignificant. In conclusion, antioxidant therapy seems to reduce the subjective discomfort and tinnitus intensity in tinnitus patients.
Collapse
Affiliation(s)
- Anna I. Petridou
- 1st ENT Department, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (A.I.P.); (I.X.); (E.K.)
| | - Eleftheria T. Zagora
- ENT Department, General Hospital of Nikaia “Agios Panteleimon”, Nikaia, 18454 Athens, Greece; (E.T.Z.); (G.K.)
| | - Petros Petridis
- ENT Department, St. Johannes Hospital, 44137 Dortmund, Germany;
| | - George S. Korres
- 2nd ENT Department, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Chaidari, Greece;
| | - Maria Gazouli
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Xenelis
- 1st ENT Department, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (A.I.P.); (I.X.); (E.K.)
| | - Efthymios Kyrodimos
- 1st ENT Department, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (A.I.P.); (I.X.); (E.K.)
| | - Georgia Kontothanasi
- ENT Department, General Hospital of Nikaia “Agios Panteleimon”, Nikaia, 18454 Athens, Greece; (E.T.Z.); (G.K.)
| | - Andriana C. Kaliora
- Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| |
Collapse
|