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Sharifi A, Rabbani Anari M, Hasanzadeh A, Ghaffari ME, Ghaedsharaf S, Zojaji M, Kouhi A. Exploring the Association of Serum Uric Acid Levels with Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241272455. [PMID: 39215477 DOI: 10.1177/01455613241272455] [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: 09/04/2024] Open
Abstract
Objectives: The role of uric acid in pathogenesis of benign paroxysmal positional vertigo (BPPV) is not fully understood. It is aimed to assess the serum uric acid levels in BPPV patients compared to healthy controls. Study design: Systematic review and meta-analysis. Methods: Web of science, PubMed, Scopus, Google Scholar, Embase, Medline, and Cochrane library were systematically searched. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Results: In total, 20 studies including 3967 participants met the inclusion criteria. Ten studies (50%) reported higher uric acid (UA) levels in BPPV patients, 4 studies (20%) indicated lower UA levels in BPPV patients, while 6 studies (30%) found no significant difference in UA levels between BPPV patients and healthy controls. The overall mean serum levels of UA (SMD: 0.265, [-0.163 to 0.693]) were higher in BPPV patients than control group. However, this difference was not statistically significant (P-value: .225). Conclusion: There is no significant difference in serum level of UA between BPPV patients and healthy controls. It means that serum level of UA (whether low or high) is not likely the underlying factor of development of BPPV.
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Affiliation(s)
- Alireza Sharifi
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| | - Mahtab Rabbani Anari
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| | - Armin Hasanzadeh
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| | - Mohammad E Ghaffari
- Faculty of Health, Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | | | - Mohaddeseh Zojaji
- Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Kouhi
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
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Janša V, Osredkar J, Verdenik I, Rižner TL, Ban Frangež H. Oxidative stress markers cannot be used as endometriosis biomarkers in infertile patients. Gynecol Endocrinol 2023; 39:2242956. [PMID: 37607570 DOI: 10.1080/09513590.2023.2242956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/14/2023] [Accepted: 07/26/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVES Endometriosis is a common benign gynaecological disease that significantly compromises the quality of life of patients. To date, invasive surgery is the method of choice to visually and histologically confirm endometriosis. Thus, there is a major interest to develop noninvasive diagnostic tools. Oxidative stress is one of the proposed mechanisms of pathogenesis and may be involved in pelvic pain, dysmenorrhea, dyspareunia, and infertility in endometriosis patients. Thus, markers of oxidative stress may serve as diagnostic biomarkers for endometriosis. DESIGN This prospective case-control study assessed erythrocyte superoxide dismutase (SOD), erythrocyte glutathione peroxidase (GPX), serum hexanoyl lysine (HEL) and peritoneal fluid HEL. PARTICIPANTS/MATERIALS, SETTING, AND METHODS We enrolled 86 women with primary infertility; the case group included 57 women with endometriosis, and the control group included 29 women with unexplained primary infertility. All the patients underwent laparoscopy, and the diagnosis was confirmed histologically. RANDOX and RANSEL reagents were used to determine the levels of SOD and GPX, respectively, and ELISA was used to determine the levels of HEL. RESULTS We found no statistically significant differences in the erythrocyte levels of GPX (p value 0.623) or SOD (p value 0.122) or the serum or peritoneal fluid levels of HEL (p value 0.562 and 0.329 accordingly). CONCLUSIONS SOD, GPX, and HEL levels most likely do not differ between patients with unexplained infertility and patients with endometriosis.
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Affiliation(s)
- Vid Janša
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joško Osredkar
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Ivan Verdenik
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tea Lanišnik Rižner
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Helena Ban Frangež
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Oh EH, Lee JO, Kim HS, Park JY, Choi SY, Choi KD, Kim JS, Choi JH. Gene expression analysis in recurrent benign paroxysmal positional vertigo: a preliminary study. Front Neurol 2023; 14:1223996. [PMID: 37475735 PMCID: PMC10354243 DOI: 10.3389/fneur.2023.1223996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
Objectives This study aimed to determine the pathophysiology of recurrent benign paroxysmal positional vertigo (BPPV) in young patients using gene expression profiling combined with bioinformatics analysis. Methods Total RNA was extracted from the whole blood of four young patients with recurrent BPPV and four controls. The differentially expressed genes (DEGs) between the groups were screened using a microarray analysis based on the cutoff criteria of |log2 fold change| > 1 and an adjusted p-value of < 0.05. Functional enrichment analysis of DEGs was performed using Gene Ontology analysis, and the protein-protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of the Interacting Genes database. Results A total of 39 DEGs were detected between the BPPV and control samples, comprising 33 upregulated DEGs and six downregulated DEGs in the BPPV group. Functional enrichment analysis indicated that the upregulated DEGs were significantly enriched in terms related to metabolic processes and the immune system. Two main pathways were extracted from the PPI network: one was associated with oxidative phosphorylation and stress and the other with the adaptive immune system and extracellular matrix degradation. Conclusion The findings of our bioinformatics analysis indicated that oxidative stress or extracellular matrix degradation due to immune-mediated inflammatory responses may contribute to the development of recurrent BPPV in young patients.
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Affiliation(s)
- Eun Hye Oh
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jin-Ok Lee
- Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Hyun Sung Kim
- Department of Neurology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Ji-Yun Park
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Seo Young Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Biomedical Research Institute, Busan, Republic of Korea
| | - Kwang-Dong Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Biomedical Research Institute, Busan, Republic of Korea
| | - Ji-Soo Kim
- Dizziness Center, Clinical Neuroscience Center, Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae-Hwan Choi
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Günizi H, Savaş HB. An evaluation of trace elements and oxidative stress in patients with benign paroxysmal positional vertigo. PLoS One 2023; 18:e0277960. [PMID: 36812180 PMCID: PMC9946263 DOI: 10.1371/journal.pone.0277960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/07/2022] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES Vertigo and Dizziness are a common complaint among the reasons for applying to the ear nose throat clinic. Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of perpheric vertigo. Oxidative stress is caused by the formation of hydroxyl radicals, superoxide anions and hydrogen peroxide, which are reactive oxygen derivatives (ROS). The aim of this study is to investigate the relationship between complaints and serum trace element and oxidative stress levels in patients with BPPV. METHODS This study was conducted with 66 adult patients who presented to the ENT policlinic with the complaint of vertigo and were diagnosed with BPPV between May 2020 and September 2020. Blood samples were taken from patients diagnosed with BPPV to measure serum Zn and Cu levels and oxidative stress levels during an attack. RESULTS The mean ages of the study patients and healthy controls were 45.7 ± 15.1 and 44.7±13.2. Female / Male ratio were 28(42.5%)/38(57.5%) and 32(48.5%)/34(51.5%) in study and control group. We found serum Cu levels were lower in the patient group (p <0.05). Serum Total Thiol and Native Thiol values were lower in patients with BPPV. Total Thiol results were statistically significant.(p<0.05) Disulfide values were significantly higher in the disease group. (P <0.05). Thiol Oxidized / Thiol Reduced ratio (2243.6±6.7/343.8±125.3) was higher in control group. (p<0.05). CONCLUSION Serum oxidative stress and trace elements play a role in the pathophysiology of BPPV. We present the cut-off values for Cu and Zn in vertigo patients for the first time in the literature. We think that these cut-off values of the trace elements and thiol/disulfide hemostasis can be used clinically by physicians in the etiology, diagnosis and treatment of vertigo.
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Affiliation(s)
- Hüseyin Günizi
- Department of Otolaryngology, Alkü Alanya Alaaddin Keykubat University Medical School, Alanya, Antalya, Turkey
- * E-mail:
| | - Hasan Basri Savaş
- Department of Clinical Biochemistry, Alkü Alanya Alaaddin Keykubat University Medical School, Alanya, Antalya, Turkey
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Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants. Audiol Res 2022; 12:445-456. [PMID: 36004953 PMCID: PMC9404917 DOI: 10.3390/audiolres12040045] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences. A total of 128 patients with high recurrence-BPPV were randomized in three arms: Arm 1 consisted of subjects with “insufficient” or “deficient” vitamin D blood levels, treated with daily oral supplementation of LICA®, vitamins of group B and vitamin D3 (800 UI), Arm 2 included BPPV subjects with “sufficient” vitamin D who did not receive any nutritional support, and Arm 3 included subjects with a “sufficient” serum concentration of vitamin D who received supplementation with a compound of LICA® and Curcumin. After six months of follow-up, a significant reduction of BPPV relapses compared to the baseline was found only in Arm 1 (−2.32, 95% CI: 3.41−1.62, p-value < 0.0001). Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV.
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Kim EK, Pasquesi L, Sharon JD. Examining Migraine as a Predictor of Benign Paroxysmal Positional Vertigo Onset, Severity, Recurrence, and Associated Falls. Cureus 2022; 14:e28278. [PMID: 36168362 PMCID: PMC9505626 DOI: 10.7759/cureus.28278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: The comorbidity of migraine and benign paroxysmal positional vertigo (BPPV) is well-established, yet the impact of migraine on the BPPV phenotype remains understudied. Methods: A retrospective analysis of patients at a tertiary dizziness/vertigo clinic diagnosed with BPPV from 2015 and 2020 was conducted. The study's primary outcomes were the age of BPPV onset, Dizziness Handicap Index (DHI), BPPV recurrence, and dizziness-related falls. Results: In our cohort of 255 BPPV patients, 44.7% had a history of migraine. Those with migraine had an earlier age of BPPV onset than individuals without migraine (60.2 vs. 65.4, p = 0.0018). Migraineurs and non-migraineurs did not differ in their DHI (44.7 vs. 41.6, p= 0.44), recurrence rates (48.3% vs. 40.4%, p= 0.21), and falls (32.5% vs. 37.6%, p = 0.39). Among individuals with horizontal canal BPPV, a higher proportion of migraineurs experienced falls than non-migraineurs (50.0% vs. 6.3%, p = 0.02). Conclusions: Migraineurs experience BPPV at a younger age than those without migraine. This finding suggests that migraine, which has been shown to cause inner ear damage, predisposes individuals to developing BPPV earlier. Migraine was also associated with a higher rate of falls among patients with horizontal canal BPPV, indicating that a migraine history may impact the phenotype of BPPV.
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Melatonin Exerts Anti-Inflammatory, Antioxidant, and Neuromodulatory Effects That Could Potentially Be Useful in the Treatment of Vertigo. Int J Otolaryngol 2021; 2021:6641055. [PMID: 33859698 PMCID: PMC8009714 DOI: 10.1155/2021/6641055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
The acute phase of vertigo involves multiple neurotransmitters, inflammatory mediators, and products of oxidative stress. The vestibular pathway has multiple melatonin receptors distributed along its path, both centrally and peripherally. In addition, melatonin has been shown to be a powerful antioxidant and anti-inflammatory agent against factors related to vertigo, such as Bax/caspases, interleukins, and chemokines. Likewise, it exerts central GABAergic, antidopaminergic, and anti-migraine functions and regulates sympathetic activity in a similar way to the drugs classically used in acute vestibular crisis. In this review, the role of melatonin as a potential treatment of the acute phase of vertigo is discussed.
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