Oxidative stress, defective proteostasis and immunometabolic complications in critically ill patients

Impact of Vitamin E-Coated Membrane Hemodiafilter on Serum Albumin Redox State in the Acute Kidney Injury Pig Hemodialysis Model

BACKGROUND

Several studies have evaluated the biocompatibility of dialysis membranes. The use of vitamin E-coated membranes has been reported multilaterally in in vitro and clinical studies. Nevertheless, the effect of vitamin E-coated membranes on the redox state of serum albumin, which forms the largest fraction of reactive sulfhydryl groups, has not been reported.

METHODS

Hemodiafiltration (HDF) with and without a vitamin E-coated hemodiafilter (V-RATM group and ABHTM groups, respectively) was performed in an acute kidney injury pig model to determine whether changes in the serum albumin, the oxidized albumin (OxiALB), and the reduced albumin (RedALB) levels differ between the two groups.

RESULTS

Analyses were conducted 22-24 times in the V-RATM group and 16-18 times in the ABHTM group, excluding missing data. The serum albumin levels decreased in both groups after nephrectomy; however, the decrease observed in the V-RATM group was significantly lesser than that in the ABHTM group. RedALB levels were significantly higher in the V-RATM group; in contrast, OxiALB levels did not differ between the two groups. A significant positive correlation was observed between the serum albumin and RedALB levels.

CONCLUSIONS

The present study demonstrated that HDF performed using a vitamin E-coated hemodiafilter effectively minimized the reduction in serum albumin and RedALB levels compared to the vitamin E-non-coated hemodiafilter in an acute kidney injury pig model.

Comparison of Oxidative Stress Markers with Clinical Data in Patients Requiring Anesthesia in an Intensive Care Unit

Objectives: The aim of this study is to assess the oxidative stress status in patients requiring intensive care unit (ICU) admission before initiating ICU treatment, by measuring the total oxidant level (TOS) and total antioxidant level (TAS) and oxidative stress index (OSI) levels. Additionally, we aim to explore the correlation between these oxidative stress markers and biochemical and hematological parameters. Materials and Methods: A total of 153 patients treated in intensive care units were included in the study. Patients who met the patient admission criteria of the ethics committee of the intensive care medicine association were included in the study. Blood samples were taken at the first moment the patients were admitted to the intensive care unit (before starting treatment). In total, 60 healthy volunteers who were compatible with the patient group in terms of age and gender were included in the study as a control group. Patients who had previously received antioxidant treatment and cancer patients were excluded from the study. Results: The TOS was significantly higher in the patient group (13.4 ± 7.5) compared to controls (1.8 ± 4.4) (p = 0.021). TOS > 12.00 means a "very high oxidant level". OSI was significantly higher in the patient group (689.8 ± 693.9) compared to the control group (521.7 ± 546.6) (p = 0.035). Ferritin levels were significantly higher in the patient group (546.5 ± 440.8 ng/mL) compared to controls (45.5 ± 46.5 ng/mL) (p < 0.001). Patients had significantly higher levels of C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBCs), immature granulocytes (IGs), zinc, and copper compared to the control group, indicating elevated inflammation and oxidative stress. CRP levels were 76.6 ± 85.9 mg/L in patients versus 5.6 ± 15.1 mg/L in controls (p < 0.001). PCT levels were 15.8 ± 8.6 ng/L in patients versus 2.3 ± 7.2 ng/L in controls (p = 0.012). Zinc and copper were also significantly elevated (p = 0.012 and p = 0.002, respectively). Conclusions: Our study provides valuable insights into the relationship between oxidative stress, inflammation, and trace elements, contributing to the growing understanding of oxidative stress as a prognostic tool in critical care. This could help to tailor therapeutic strategies aimed at reducing oxidative damage in ICU patients, enhancing patient outcomes.