Plasma and Erytrocyte Oxidative Stress Markers in Children with Frequent Breath-Holding Spells

Abstract

Background Breath-holding spells (BHS) are common non-paroxysmal events with unknown pathophysiology. BHS have been associated not only with iron deficiency anemia (IDA) but also with oxidant/antioxidant imbalance and erythrocyte injury induced by hypoxia. The present study was designed to investigate the contribution of IDA in BHS and the oxidant/antioxidant balance in children with or without IDA in BHS and compare them with healthy controls.Additionally, the study also aimed to examine the effect of the frequency of BHS attacks (mild or severe) on the oxidant/antioxidant balance and to determine the best predictive oxidant and antioxidant markers. Materials and Methods The study included 66 children with BHS aged 6–48 months who had been followed up for a minimum period of one year between 2014 and 2018. A control group of 30 age- and gender-matched healthy children was included in the study. The patient group was divided into 2 groups (IDA and non-IDA) and these groups were compared between each other and also with the control group. The IDA group was divided into subgroups based on the frequency of BHS attacks. Blood samples were obtained within a maximum period of 24 h following the spell. Levels of protein carbonyl, nitrite, nitrate, TOS, TAS, OSI, MDA, enzyme activities of GPx, CAT,enzyme activities of erythrocyte SOD, CAT, and GPx, and the level of MDA were measured. Results In patients with IDA, the oxidant levels increased while the antioxidant enzyme activities decreased. In all patients, the levels of MDA, carbonyl, TOS, OSI increased and the levels of TAS, activities SOD, and CAT decreased, whereas the enzyme activities of erythrocyte SOD, CAT, GPx decreased significantly compared to those of control group. Increased of erythrocyte MDA levels had 10.32, decreased enzyme activities of erythrocyte SOD levels had a 10.25, and decreased enzyme activities of erythrocyte CAT had a 5.33 times greater risk for spell. Conclusion The results indicated that the oxidant/antioxidant balance in children with BHS was impaired in favor of oxidants at both levels, regardless of the presence of IDA and the increased frequency of BHS attacks per day. Moreover, the presence of IDA was found to be associated with increased oxidative stress in children with BHS, particularly at the erythrocyte level. Erythrocyte level; among the erythrocyte MDA oxidant parameters, erythrocyte SOD and antioxidant parameters, they are the biomarkers that show the best probability of having a BHS attack and an increase in the frequency of apnea attacks.

Malondialdehyde as a Potential Oxidative Stress Marker for Allergy-Oriented Diseases: An Update

“…The analysis of MDA levels in blood samples has been extensively employed to investigate the role of oxidative stress in airway diseases. Various studies have examined different methodologies for measuring MDA in this sample, including serum, erythrocyte and lymphocyte MDA levels (S-, E- and L-MDA) [ 44 , 45 , 46 , 47 , 48 ]. However, the accurate measurement of MDA in biological samples can pose challenges due to its instability and susceptibility to degradation.…”

Dynamic Thiol-Disulfide Homeostasis in Children with Newly Diagnosed Iron Deficiency Anemia

“…Membrane changes and damage to erythrocytes due to ROSinduced oxidative stress, have been demonstrated (17). Several studies have reported that the concentrations and activities of antioxidant enzymes such as glutathione peroxidase (GSH-Px), catalase (CAT) and superoxide dismutase (SOD) decreased and oxidant stress increased in IDA (18,19). Aycicek et al (20), have found that total oxidant status (TOS) and oxidative stress index (OSI) were higher in patients with IDA, while total thiol (-SH) and total antioxidant capacity (TAC) levels were lower than in the control group.…”