Letter to the EditorImplication of oxidative stress and its correlation with activity of matrix metalloproteinases in patients with Takayasu's arteritis disease
Introduction
The aetiopathogenesis of Takayasu's arteritis (TA) disease remains enigmatic and various mechanisms such as post-infective, autoimmune, ethnic susceptibility and a genetic predisposition have been postulated [1]. The diagnosis of this disease is difficult, because only non-specific symptoms may be present during the early phase of TA, symptoms of arterial stenosis and occlusion are late phase manifestations and the current diagnostic criteria focus mainly on these manifestations [2]. The disease tends to progress despite treatment with glucocorticoid/immunosuppressive agents and selection of an appropriate therapeutic strategy is based on monitoring the severity of the disease [3], [4].
Oxidative stress is a cardinal feature of the inflammatory process and has been generally considered to be uniformly deleterious in vascular abnormalities. An obvious mechanism of oxidative stress (e.g. in the form of reactive oxygen species (ROS) and reactive nitrosative species (RNS)) is through oxidative damage to cellular proteins, membranes and DNA [5], [6]. Another mechanism is the potential of ROS and RNS to influence extracellular matrix remodeling through activation of matrix metalloproteinases (MMPs) [5], [6]. 8-isoprostaglandin F2α (8-iso-PGF2α) has been shown to be a sensitive and specific biomarker of the oxidative stress in vivo and is a member of isoprostane family which have been shown to exert potent biological actions [5], [7].
Though, deeply explored in other diseases, the degree of oxidative stress and its relation to Takayasu's arteritis is unclear. Also, how oxidative stress and MMP activity are linked together in the aetiopathogenesis of TA disease is not known. The aim of the present study is to investigate whether oxidative stress indices i.e. (8-iso-PGF2α and NO2−) and MMP activity could correlate with the disease activity.
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Materials and methods
40 patients with angiographically proven Takayasu's arteritis (Group I) and 40 normal healthy controls (Group II) were enrolled in the present study as described earlier [8]. The study has been approved by The Institutional Ethics Committee.
Plasma 8-iso-PGF2α was determined in all the study subjects using commercially available immunoassay kit (Assay Designs, USA). Plasma nitrite (NO2−), as a stable end product of NO production and DNA damage was determined as described previously [9]. Gelatin
Results
The baseline characteristics of the subjects are shown in Table 1. We observed no significant difference between the two study groups as far as lipid and lipoprotein profile, blood urea, serum creatinine and uric acid levels are concerned (p > 0.05; data not shown). Levels of 8-iso-PGF2α and NO2− were found to be significantly higher in patients with TA as compared to the normal healthy subjects (p < 0.01). Further, we also observed higher levels of 8-iso-PGF2α and NO2− in TA patients with active
Discussion
Takayasu's arteritis (TA) is a progressive inflammatory and occlusive disease of the unknown origin and mainly affects the aorta and its branches, as well as the pulmonary and coronary arteries [2]. However, the current focus of the research is on newer developments which have taken place with regard to etiology, diagnosis of disease activity and management aspects.
Augmented levels of 8-isoPGF2α in TA patients reflects enhanced lipid peroxidation which may possibly be due to an acute
Acknowledgements
The authors thank the Indian Council of Medical Research (ICMR), New Delhi for research funding. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [20].
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