Markers of the oxidative stress and antioxidant system in pulmonary drug susceptible and drug resistant tuberculosis

Abstract

Background: The oxidative stress biomarkers in tuberculosis were studied, but the differences between the pulmonary drug susceptible and drug resistant forms were not identified. Material and methods: A prospective, case-control study, which included 51 patients, distributed in 2 groups: the 1st study group (N=24 new cases with drug susceptible tuberculosis) and the 2nd group (N=27 new cases with MDR-TB) similar distributed according to the sex and age were compared with a control group constituted from 36 healthy persons. The intensity of the oxidative stress was appreciated through the serum concentration of the advanced oxidation protein products, lysosomal marker N-acetil-β-D-glucosaminidase, advanced glycation end-products (AGEs ). The antioxidant defense was assessed through the total serum antioxidant activity, the activity of the glutathione enzymes and proteins with antioxidant role. Results: In MDR-TB carbohydrate peroxidation biomarker versperlysines-like AGEs was diminshed, as well as the serum antioxidant defense assessed through CUPRAC method. In drug susceptible tuberculosis was established the elevation of the protein peroxidation, high lysosomal membrane damage and increased acute phase protein – ceruloplasmine. Antioxidant enzyme glutathione S-transferase had lower activity in both types of tuberculosis which contributed to the increasing of the γ-glutamyltransferase. Conclusions: The oxidative stress level was more elevated in drug susceptible tuberculosis and antioxidant defense was more impaired in the MDR-TB group. The antioxidant biomarker – glutathione S-transferase activity, was lower in both types of tuberculosis which increased the γ-glutamyltransferase activity. The polymorphism assessment of the glutathione S-transferase enzyme is important for the individualized therapy and reducing the toxicity of the anti-tuberculosis treatment