Prooxidant and antioxidant systems’ indices as the markers of endogenous intoxication in ronchopathy and syndrome of obstructive sleep apnea in the dynamics of treatment

Abstract

Introduction: Ronchopathy is a chronic progressive disease manifested by upper airway obstruction and chronic respiratory failure. The key process of pathological snoring is the obstructive breathing disorders. The obstructive sleep apnea syndrome (OSAS) develops on the basis of snoring. OSAS is accompanied by episodes of hypoxia and reoxygenation, which cause an increase of the level of reactive free radicals whith following development of the oxidative stress. The activation of peroxidative processes of proteins (POP) and lipids (POL) are initiated by free radicals which are noticeable components of endogenous intoxication (EI). The aim of the study was to investigate the intensity of POP and POL processes, the levels of OSAS components, and the indices EI in patients with ronchopathy and OSAS of varying severity in the dynamics of treatment. Materials and methods: 40 patients with ronchopathy and OSAS were examined at the State Institution “Institute of otolaryngology named after prof. O.S. Kolomiychenko of the National Academy of Medical Sciences of Ukraine”. All patients were divided according to the degree of snoring and hypoxia index (HI) into 4 groups of 10 persons each. Control group was formed by 10 healthy donors. The object of biochemical studies was blood serum. The intensity of POP was assessed by reaction with 2,4-dinitrophenyl-hydrazine by the Levin’s method in Reznick’s modification. POL intensity was determined by the interaction with 2-thiobarbituric acid (TBA) by Goncharenko. Catalase activity was determined by the method of Korolyuk and co-authors. The content of free thiol groups was determined by interaction with 5,5'-dithio-bis(2-nitrobenzoic acid). The content of medium weight molecules (MWM) and tyrosine-containing peptides (TCPs) were determined by spectroscopy at 254 and 280 nm, respectively. Statistical processing of the results was performed using the software package for biometric data WinPEPI. Results: Prior to the treatment in patients with ronchopathy and OSAS of varying severity, an increase in the content of MWM and TCPs were noted, that indicates the development of endogenous intoxication. In patients of all groups there was an intensification of POP, which was manifested by a significant increase of aDNFGn, aDNFGo, and kDNFGn levels. The content of TBA-positive products in patients with ronchopathy of both groups was at the level of control and increased significantly at progression of pathological process. In addition, in all groups of patients an increase of catalase activity was detected on the background of TCPs level decrease. It was found the efficacy of the offered treatment of patients with ronchopathy and OSAS of varying severity. The indices of EI, POP, POL, and antioxidant system’s were directed to improvement in contrast to the state before treatment, and some of them were improved almost to the level of control. Conclusions: It is established that the progression of hypoxia is accompanied by autointoxication, which is manifested by an increase in the content of MWM, as well as prove for the activation of catabolic reactions and excessive formation of cells’ breakdown products. It was also revealed by the intensification of POP and POL processes, the activation of which are associated with the development of insufficiency of enzymatic and nonenzymatic components of antioxidant system. The performed treatment can be considered as the effective one since on its completion all the studied indices were restored almost to the level of control.