Paraoxonase and arylesterase activity and total oxidative/anti-oxidative status in patients with chronic adenotonsillitis

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Abstract

Objectives

The aim of this study was to investigate serum paraoxonase, arylesterase activities along with determination of oxidative status via measurement of total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) in children with recurrent adenotonsillitis during pre- and post-adenotonsillectomy period and to compare results with data from healthy subjects.

Methods

We performed a prospective controlled trial on adenoidectomy and/or tonsillectomy patients. A total of 47 subjects, including 22 patients with recurrent adenotonsillitis and 25 healthy controls were enrolled in this study. Peripheral venous blood samples were taken from patients before adenotonsillectomy and a second sample was obtained in first month postoperatively. In the control group, blood samples from healthy volunteers were collected for one time only. Serum paraoxonase, arylesterase activities, TOS, TAS and OSI levels were measured.

Results

Paraoxonase, arylesterase activity, TAS and TOS levels were significantly higher in preoperative group compared to control group (P < 0.001, P = 0.003, 0.003 and 0.005, respectively). However, OSI level was similar in preoperative group compared to control group (P = 0.25). In the post-operative group, paraoxonase, arylesterase activities, TAS and OSI levels were lower as compared to preoperative group but differences were statistically insignificant (P = 0.483, 0.265, 0.149 and 0.090, respectively). TOS level in post-operative group was significantly lower than the preoperative group (P < 0.001). In the post-operative group, paraoxonase and arylesterase activities were significantly higher as compared to control group (P = 0.004 and 0.02, respectively). TOS and OSI levels were significantly lower in post-operative group compared to control group (P = 0.001 and 0.02, respectively). However, TAS was similar between post-operative and control groups (P = 0.464).

Conclusions

Based on data obtained from this study, we may state that paraoxonase, arylesterase activities with TAS, TOS and OSI levels of patients with chronic adenotonsillitis shows alterations due to oxidant/antioxidant imbalance induced by frequent infections.

Introduction

Tonsillectomy and/or adenoidectomy are the most common surgical operations performed by otolaryngologist in paediatric population. Routine indications for tonsillectomy and/or adenoidectomy are upper airway obstruction, recurrent adenotonsillitis and eustachian tube dysfunction [1]. Pathophysiology of adenotonsillary disease is still unclear. In aerobic organisms, reactive oxygen species (ROS) are produced during normal immune defense and metabolic activity [2]. Rate of production and destruction of ROS is in a state of balance, which is known as oxidative balance. In cases where this oxidative balance is maintained, ROS have no impact on the organism but in cases where this balance is destroyed in favor of free radicals, oxidative stress develops [3]. Oxidative stress is a consequence of relative overproduction of ROS, as seen in inflammation [4]. Defense system protecting free radical damage involves enzymatic and non-enzymatic antioxidant systems. Enzymatic system includes superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and catalase (CAT). On the other hand, non-enzymatic system includes various substances like vitamin E, vitamin C, beta-carotene, glutathione, uric acid, bilirubin and retinol [5]. Paraoxonase is a high-density lipoprotein (HDL)-associated antioxidant enzyme. In various trials, it was shown that paraoxonase prevents oxidative stress by inhibiting oxidation of cell membrane lipids induced by ROS which develop in acute and chronic inflammation [6], [7].

The aim of this study was to investigate serum paraoxonase and arylesterase activities along with determination of oxidative status via measurement of total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) in children with recurrent adenotonsillitis during pre and post-operative period and to compare results with data from healthy subjects.

Section snippets

Subjects

We performed a prospective controlled trial on adenoidectomy and/or tonsillectomy patients. Study was approved by Ethical Committee of Cumhuriyet University, Medical Faculty.

A total of 47 subjects, including 22 patients with recurrent adenotonsillitis and 25 healthy controls were enrolled in this study. Children with chronic underlying diseases (including cardiovascular disorders, malignancy, asthma, allergic rhinitis, cystic fibrosis, metabolic disease, renal or liver disease or

Results

Chronic adenotonsillitis group consisted a total of 22 children, 13 (59%) boys and 9 (41%) girls, aged 8 ± 2 and control group consisted 25 children, 15 (60%) boys and 10 (40%) girls, aged 9 ± 4. There were no significant differences between chronic adenotonsillitis group and control groups in terms of age and gender.

As seen in Table 1, paraoxonase, arylesterase activity, TAS and TOS levels were significantly higher in preoperative group compared to control group (P < 0.001, P = 0.003, 0.003 and 0.005,

Discussion

In order to evaluate the impact of chronic adenotonsillitis on oxidative status, we measured paraoxonase, arylesterase activities with TAS, TOS and OSI levels. To the best of our knowledge, there is no study reported in the literature related to paraoxonase, arylesterase activities with TOS, TAS and OSI levels in patients with adenotonsillary disease. Reactive oxygen species may be defined as any species including one or more unpaired electrons. Because they are extremely reactive, they have

References (34)

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