Search

Background: Oxidative stress results from an imbalance between the induction of reactive oxygen species and the ability of cells to metabolize them. Numerous markers can be used to assess the level of oxidative stress. Thiol-disulfide homeostasis (TDH) and ischemia-modified albumin (IMA) are some of them. The aim of this study is to investigate the role of TDH and IMA, which are indicators of oxidative stress, in older patients with osteosarcopenia (OS)., Methods: The study was conducted cross-sectionally in a geriatrics outpatient clinic. Patients who applied to the outpatient clinic for three months were included in the study. Patients with acute infection, delirium, malignancy, severe liver, heart or kidney dysfunction and who did not give their consent for the study were excluded from the study. The study was conducted with 136 patients. Sarcopenia was diagnosed according to muscle ultrasonography (USG) and handgrip strength (HGS) results. Osteopenia/osteoporosis was diagnosed according to bone mineral densitometry (BMD) results. The combination of osteopenia/osteoporosis and sarcopenia was accepted as OS., Results: Native thiol, total thiol value and nativethiol /totalthiol*100 values were significantly lower in the group with OS (respectively; value = 265 ± 53.8 standard deviation (SD) μmol/L, p =  ≤ 0.001; value = 295.33 ± 55.77 SD μmol/L, p = 0.001; value = 90.06 (2.8) interquartile ranges (IQR), p = 0.033). Disulfide/native thiol*100 and disulfide/total thiol*100 values were significantly higher in the group with OS (respectively; value = 5.5 (1.7) IQR, p = 0.033; value = 4.97 (1.4) IQR, p = 0.034)., Conclusion: In our study, the role of oxidative stress in OS was demonstrated by using TDH as an oxidative stress parameter., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Objectives: Thiols play an important role in defense against reactive oxygen species. We aimed to evaluate the relation between oxidative stress, glucose tolerance, and sleep quality in kidney transplant recipients without diabetes., Materials and Methods: We enrolled 95 kidney transplant recipients without diabetes from living and deceased donors with stable allograft function and 60 healthy controls. We included recipients who received a kidney from a living donor with a first-degree relation. Insulin resistance was determined using the Homeostasis Model Assessment score. Native thiol, total thiol, and disulfide levels were measured, and disulfide versus native thiol/total thiol ratios were calculated from all patients. We used the Pittsburg Sleep Quality Index to assess sleeping patterns. According to standard cutoff value of the index (≤5 indicates good quality sleep; >5 indicates poor sleep quality), we stratified kidney transplant recipients as group 1 (Pittsburg Sleep Quality Index ≤5; n = 41) and group 2 (Pittsburg Sleep Quality Index >5; n = 54)., Results: In correlation analysis, Pittsburg Sleep Quality Index was positively correlated with age, the Homeostasis Model Assessment score, body mass index, serum disulfide levels, disulfide/total thiol ratio, and native/total thiol ratio. The Pittsburgh Sleep Quality Index was negatively correlated with total thiol levels. In subgroup analysis, the Homeostasis Model Assessment score, disulfide levels, and disulfide/total thiol and native/total thiol ratios were significantly lower in group 1; however, total thiol level was significantly higher in this group. In multivariate regression analysis, age, the Homeostasis Model Assessment score, disulfide/total thiol ratio, and renal resistivity index were detected as predictors of sleep quality score., Conclusions: Sleep quality moderates oxidative stress identified by thiol-disulfide homeostasis and insulin resistance in renal transplant recipients without diabetes.

Objective: We aimed to examine the effect of remission status on thiol-disulfide homeostasis in celiac patients and thus to indirectly determine the effect of oxidative stress and inflammation caused by non-compliance with the diet., Methods: Between February 2019 and December 2021, 117 patients diagnosed with celiac disease were included in this prospective randomized and controlled study. In addition to routine tests of celiac patients, thiol and disulfide measurements were made from the blood both at the beginning of the study and at the end of the first year., Results: While 52 of the patients (44.4%) were in remission, 65 patients (55.6%) were not. There was an evident increase in native thiol levels of the patients who were initially not in remission but went into at the end of the first year (347.4±46.7 μmol/L vs. 365.3±44.0 μmol/L; p=0.001). Mean plasma disulfide levels of patients with celiac going into remission became reduced in the first year from the level of 14.5±5.1 μmol/L down to 8.9±4.2 μmol/L (p<0.001). In celiac patients who entered remission, disulfide and anti-tissue transglutaminase immunoglobulin A levels decreased in a correlation (r=0.526; p<0.001)., Conclusion: Not being in remission in celiac disease leads to increased oxidative stress, and thiol-disulfide homeostasis is an indirect indicator of this. Additionally, providing remission in celiac patients reduces oxidative stress.

Objectives: In this study, we investigated dynamic thiol-disulfide homeostasis as a new indicator of oxidative stress in lung transplant recipients. In addition, we compared dynamic thiol-disulfide homeostasis parameters according to transplant indication and time after transplant., Materials and Methods: This study had a single-center, observational, randomized design. In terms of transplant indications, lung transplant recipients were grouped as chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, and other indications. To make comparisons based on time after transplant, lung transplant recipients were categorized into the following groups: >6 and ≤24 months, >24 and ≤48 months, >48 and ≤72 months, and >72 months. A fully automated spectrophotometric technique was used to measure dynamic thiol-disulfide homeostasis in fasting blood samples., Results: Our study included 34 lung transplant recipients and 36 healthy volunteers. Native thiol (P = .005) and total thiol levels (P = .06) were lower in lung transplant recipients. Disulfide levels were similar. Disulfide-to-native thiol (P = .027) and disulfide-to-total thiol ratios (P = .027) were significantly higher in lung transplant recipients. Native thiol-to-total thiol ratios were lower in lung transplant recipients (P = .027). When we examined patients according to transplant indication, no statistically significant differences were found in dynamic thiol-disulfide homeostasis parameters, except for total thiol and disulfide levels. We also found no significant differences when we examined dynamic thiol-disulfide homeostasis parameters according to time after transplant., Conclusions: Thiol-related antioxidant activity is significantly reduced after lung transplant, regardless of indication and transplant time. Ensuring oxidative balance in lung transplant recipients with an antioxidant supplement regimen can prevent damage from oxidative stress.

Objective: The purpose of this study is to evaluate antioxidant balance in pregnant women with meconium-stained amniotic fluid., Methods: Forty pregnant women with meconium-stained amniotic fluid and 40 pregnant women with non-meconium-stained amniotic fluid were included in the study. By checking the ischemia modified albumin (IMA) level and thiol/disulfide homeostasis in the maternal blood during labor and in newborn umbilical cord blood at the first minute after birth, antioxidant/oxidant balance was evaluated., Results: No statistically significant difference was found between the maternal albumin levels. Maternal IMA level was statistically significantly higher in the meconium group than in the control group ( p = .045). Maternal native thiol (SH) and maternal total thiol levels were statistically significantly higher in the control group than in the meconium group ( p = .042 and p = .009, respectively). No statistically significant difference was found between maternal disulfide/native thiol ( p = .262), maternal disulfide/total thiol ( p = .152), maternal native thiol/total thiol ( p = .153) rates in both groups. No statistically significant difference was determined between the patients with meconium and the control group in terms of cord blood IMA ( p = .474), Albumin levels ( p = .664), cord blood Native thiol ( p = .944), cord blood total thiol ( p = .612) levels and cord blood disulfide/native thiol ( p = .240), cord blood disulfide/total thiol ( p = .276), cord blood native thiol/total thiol ( p = .277) rates., Conclusion: Determination of a decrease in SH and Total Thiol levels in maternal serum and an increase in the meconium group's IMA level was interpreted as a shift of antioxidant balance toward oxidant in this group.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. The pathogenesis of HS is not clear, and the triggering mechanism for the initiation of the disease is still a controversy., Aims: The present study aims to investigate the relationship between thiol-disulfide homeostasis (TDH), ischemia-modified albumin (IMA), and HS. To our knowledge, this will be the first report evaluating TDH and IMA status in HS., Patients/methods: The study included 30 patients with HS as the patient group and 30 healthy individuals as the control group. For determination of HS severity, Hurley and Hidradenitis suppurativa physician global assessment (PGA) scores were used. One tube venous blood specimen from every participant was obtained. IMA and TDH tests were analyzed in sera of participants. The results were evaluated statistically., Results: Disulfide (p < 0.001), Index I (p = 0.001), and Index II (p = 0.001) levels in HS group were significantly higher than control group. IMA levels in patients with higher Hurley scores are significantly higher (p = 0.032, r = 0.39). A positive correlation was observed between IMA level and disease duration (p = 0.021, r = 0.42)., Conclusions: The shift in thiol/disulfide balance toward disulfide and significant increase in IMA levels put out the importance of oxidation status in HS etiopathogenesis., (© 2022 Wiley Periodicals LLC.)

Aim: We investigated the association of fetal serum thiol/disulfide homeostasis and ischemia-modified albumin (IMA) levels with fetal distress (FD). Methods: Umbilical cord blood for native thiol, total thiol, disulfide, albumin, and IMA analysis was obtained from 44 pregnant women over 34 weeks gestation undergoing cesarean section due to non-acute FD, and from 61 healthy pregnant women who underwent elective cesarean section Results: Native thiol and total thiol levels were significantly lower in the FD group ( p  = 0.02 and p  = 0.014, respectively). Although disulfide/native thiol and disulfide/total thiol ratios were higher in the FD group, the difference was statistically insignificant ( p  = 0.805). The IMA levels were significantly higher in the FD group ( p  = 0.013). Conclusion: The thiol-disulfide homeostasis shifts toward the oxidant direction during the FD pathogenesis and the increased IMA levels may be the best indicator of an underlying non-acute ischemic condition.

Idiopathic male infertility (IMI) is the absence of a reason to explain a patient's infertility, and it occurs at a frequency of %31. In this study we aimed to investigate the oxidant/antioxidant status of patients with IMI and compare their results to those of healthy controls.A total of 79 patients with IMI (group 1) and 90 healthy individuals (group 2) were included in the study. We used Erel & Neşelioğlu's thiol/disulfide homeostasis test. Collective and individual measurements of oxidative/antioxidative balance components were carried out by this novel thiol/disulfide homeostasis test. Serum antioxidant (total thiol (toSH), native thiol (SH)) and oxidant (disulfide (SS)) levels of all study participants were measured. The results from both groups were compared and analyzed statistically. After toSH, SH, and SS levels were determined, SS/toSH% and SS/SH% levels for each group were analyzed separately and compared statistically.The toSH, SH levels, and SS/SH%, SS/toSH% ratios were significantly different between the groups (p < 0.05).While antioxidant parameters (toSH and SH values) decreased in group1, oxidant parameters (SS/SH%, SS/toSH%) increased significantly. Although SS values were higher in group 1, the difference was not significant (p = 0.214). The SH cutoff value of 507.15 µmol/L predicted the probability of IMI development with 72.2% sensitivity and 74.4% specificity and toSH cutoff value of 545.45 µmol/L predicted IMI development with 70.9% sensitivity and 73.3 specificity (p < 0.001). Multivariate logistic regression analysis showed that the only independent risk factor for the development of IMI is SH. Patients with IMI had a significant change in their thiol/disulfide homeostasis, which suggests the involvement of this imbalance in the pathophysiology of IMI. Furthermore, these results also support the notion of the involvement of oxidative stress in sperm dysfunction. It also points to the possibility of using antioxidants in IMI treatment. Abbreviations: IMI: idiopathic male infertility; toSH: total thiol; SH: native thiol; SS: disulfide; OS: oxidative stress; ROS: reactive oxygen species; DCF: dichlorofluorescein; MiOXSYS: male infertility oxidative system; MOSI: male oxidative stress infertility; LC: L-carnitine; LAC: L-acetylcarnitine; Vit: vitamin; OAT: oligoasthenozoospermia; TMSC: total motile sperm count; WHO: World Health Organization; BMI: body mass index; DTNB: 5,5'-dithiobis-2-nitrobenzoic acid; CV: coefficient variation; ROC: receiver operating characteristic; PR: progressive, NP: non-progressive.

We aim to determine serum dynamic thiol/disulphide homeostasis with novel methods in early-stage osteoarthritis and late-stage osteoarthritis patients and investigated whether it was associated with the progression of osteoarthritis risk or not. One hundred eighteen patients were included in this prospective study. Osteoarthritis patients were divided into five stages, according to the Kellgren-Lawrence scale. Dynamic thiol/disulphide homeostasis was determined with a novel spectrophotometric method. Late-stage osteoarthritis patients had significantly lower levels of native and total thiol than the patients of early-stage osteoarthritis. Disulphide, index-1, index-2 levels, and WOMAC score of late-stage osteoarthritis patients were significantly higher than the ones belonging to patients of early-stage osteoarthritis. Decreased native thiol and total thiol levels and increased WOMAC score and disulphide levels were independently associated with increased risk of late-stage osteoarthritis. We suggest that both WOMAC score and dynamic thiol/disulphide homeostasis may be implicated in the pathogenesis and progression of osteoarthritis. We also recommend that dynamic thiol/disulphide homeostasis may have clinical utility as possible markers of differential diagnosis of early-stage and late-stage osteoarthritis.

Objective: To determine the changes in thiol/disulphide homeostasis in patients determined with asymptomatic cholelithiasis and to investigate any potential correlation between these thiol-disulphide parameters and HDL cholesterol., Study Design: A descriptive, comparative study., Place and Duration of Study: Ankara City Hospital between 15 September and 31 December 2019., Methodology: This study included 42 patients aged 18-70 years, who presented at the Gastroenterology Clinic and were diagnosed with cholelithiasis on ultrasound examination. A control group was formed of 51 healthy volunteers aged 18-70 years. Thiol/disulphide homeostasis and HDL cholesterol was noted and compared between the groups., Results: The mean age was 44.16 ± 13.35 years in cholelithiasis patient group and 31.88±13.27 years in the control group. The triglyceride, VLDL, total cholesterol/HDL, and non-HDL levels were significantly higher and HDL level was significantly low in the patient group (both p <0.05). Regarding thiol-disulphide balance, native thiol, total thiol, and albumin values were found to be statistically significantly low in the patient group (p <0.05), and the IMA, index-1, index-2, and index-3 values were significantly high (p <0.05)., Conclusion: The oxidant/antioxidant balance shifted towards oxidation in patients with asymptomatic gallstones. The non-HDL value was increased. There was a positive correlation between the thiol-disulphide parameters and the non-HDL value. The increasing non-HDL amount could be effective in the pathogenesis of gallstone disease by disrupting the oxidative balance., Key Words: Cholelithiasis, Thiol-disulphide homeostasis, Lipid profile, Non-HDL, HDL, Oxidative stress.

Purpose: The role of oxidative stress in the pathogenesis of pterygium is still unclear. However, abnormal thiol disulfide homeostasis levels are involved in the pathogenesis of various systemic or ocular diseases. We aim to analyze dynamic thiol disulphide homeostasis in patients suffering from conjunctival pterygium using a contemporary technique., Methods: Thirty-eight subjects suffering from pterygium and 35 age-gender matched healthy volunteers were recruited for the study. For each case, total thiol, disulfide and native thiol levels in blood were obtained. Additionally, the ratio of disulfide over total thiol, native thiol over total thiol and disulfide over native thiol were computed., Results: The level of median native thiol was lower in pterygium group (318.2 µmol/L vs. 333.4 µmol/L) and median disulfide was slightly higher in pterygium group (24.3 µmol/L vs. 22.8 µmol/L) compared to control group. Both disulfide over total thiol and disulfide over native thiol ratios were higher in pterygium group, ratio of native thiol over total thiol was found to be higher in control group. Nevertheless, none of those differences were statistically significant at 95% confidence level. Notably, correlation test pointed to a negative correlation both between pterygium grade and native thiol and between total thiol and pterygium grade in pterygium group (P = 0.03 and 0.02, respectively)., Conclusion: A negative correlation hinting that slightly weakened dynamic thiol disulphide homeostasis in subjects with pterygium, a local ocular disease. Further studies with larger sample sizes may shed light on this potential relationship and justify systemic antioxidant therapies in these cases., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: To investigate the effects of low-flow and high-flow anesthesia techniques, administered with sevoflurane during laparoscopic cholecystectomy, on thiol/disulphide homeostasis and serum ischemia-modified albumin (IMA) levels., Study Design: Double-blind, randomised study., Place and Duration of Study: Department of Anesthesiology and Reanimation, Health Science University, Bursa Yuksek Ihtisas Training and Education hospital, Bursa, Turkey from January to October 2020., Methodology: Patients over the age of 18 years, scheduled for elective laparoscopic cholecystectomy, were included in the study. The patients were divided into two groups: Group 1 (low-flow, 1 L/min) and Group 2 (high-flow, 2 L/min). The blood samples for thiol/disulphide homeostasis and serum IMA levels were collected as follows: 5 minutes before induction of anesthesia (T0), 5 minutes after induction of anesthesia (T1) and postoperative 24th hour (T2)., Results: The final analysis included 104 patients. The two groups did not differ significantly in terms of any of the demographic characteristics (p >0.05). There were also no inter-group differences in terms of thiol/disulphide homeostasis parameters or serum IMA levels at T0, T1, or T2. However, in both groups, there were statistically significant changes in serum disulphide and IMA levels from T0 to T1 and T0 to T2 (p=0.000, and p=0.005, respectively)., Conclusion: There was no difference between low-flow and high-flow anesthesia during laparoscopic cholecystectomy in terms of hemodynamics or thiol/disulphide homeostasis. Key Words: Low-flow anesthesia, High-flow anesthesia, Thiol/disulphide homeostasis, İschemia-modified albumin (IMA), Laparoscopic cholecystectomy.

Purpose: Thiols are sulfhydryl-containing organic compounds that have an important role in preventing cellular oxidative stress. This study compares the blood oxidative stress marker levels in bronchiectasis cases during their stable periods with healthy controls., Materials and Methods: Seventy-seven patients (49 patients with stable bronchiectasis/28 healthy controls), followed up by the chest disease clinic, were included in the study. Peripheral blood thiol-disulfide parameters (NT: native thiol (-SH); TT: total thiol (-SH + SS); SS: disulfide (-SS); SS-SH: disulfide/native thiol index; SS-TT: disulphide/total thiol index; SH-TT: native thiol/total thiol index), and ischemia-modified albumin (IMA) levels were examined in the stable bronchiectasis group and the control group. Thiol-disulfide homeostasis was evaluated using a novel and automated assay. Findings and Result . Blood native thiol levels in patients with stable bronchiectasis were found to be significantly higher compared with healthy controls. A positive correlation between the total airway disease score and IMA levels was present. Our findings revealed that native thiol levels, which constitute a part of the antioxidant defense system, are increased in patients with stable bronchiectasis., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Songul Ozyurt et al.)

Objective: We aimed to investigate the effects of hypotensive anaesthesia on oxidative stress with serum thiol/disulphide balance in patients undergoing elective septoplasty procedures under general anaesthesia., Methods: Seventy-two patients between the ages of 18-60, with a physical condition I -II, according to the American Society of Anesthesiologists, were included in this prospective observational study. Septoplasty was chosen for standard surgical stress. According to the maintenance of anaesthesia, patients were divided into the groups as Hypotensive Anaesthesia (n = 40) and Normotensive Anaesthesia (n = 32). Serum thiol/disulphide levels were measured by the method developed by Erel & Neşelioğlu., Results: The native thiol and total thiol values of both groups measured at the 60th min intraoperatively were significantly lower than the preoperative values (both P < .01). Intraoperatively, at the 60th min, there was no significant difference in terms of post-native thiol and post-total thiol levels between hypotensive and normotensive anaesthesia groups (P = .68 and .81, respectively). Age >40 years and female gender were found to have a significant effect on dynamic oxidative stress (P = .002 and .001, respectively)., Conclusion: This pilot study has found that hypotensive anaesthesia had no adverse effect on dynamic thiol/disulphide balance in elective surgeries., (© 2021 John Wiley & Sons Ltd.)

Background: Chronic inflammation and oxidative stress are the most known mechanisms in Rheumatoid Arthritis (RA) pathophysiology, which is still not fully elucidated. In this study, we evaluated oxidative status by determining intracellular reduced/oxidized glutathione (GSH/GSSG) homeostasis and serum thiol/disulfide (SH/SS) homeostasis in RA patients., Methods: A total of 152 RA patient and 89 healthy controls were included in the study. RA patients were subdivided according to disease activity score-28 (DAS-28) as active RA and remission RA. Intracellular GSH/GSSG and serum SH/SS homeostasis parameters were analyzed., Results: Median (1st-3rd quartile values) SS/SH and GSSG/GSH percent ratio levels were significantly higher in RA patients (6.94 (6.02-8.54) and 69.8 (44.05-85.29); respectively) compared to controls (4.62 (4.15-5.46) and 34.9 (22.43-62.2); respectively) (p < 0.05 for all). SS/SH and GSSG/GSH percent ratio levels were significantly higher in active RA patients when compared to remission RA patients and controls (p < 0.05 for all). SS/SH and GSSG/GSH percent ratios were significantly increased in remission RA group compared to controls (p < 0.05 for all). DAS28 scores were positively correlated with SS/SH and GSSG/GSH percent ratios (rho = 0.259 and 0.296; respectively)., Conclusions: These findings suggest that active intracellular and extracellular thiol group oxidation process might play a role in RA pathogenesis and further work in these areas may be warranted to show potential value of evaluating intracellular GSSG/GSH and serum SH/SS balances together in disease monitoring., (Copyright © 2021 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Objective: To determine the relationship of oxidative stress status with follow-up parameters, metabolic control status, and treatment compliance evaluation in patients diagnosed within toxication type inherited metabolic disease (IMDs)., Study Design: Descriptive, analytical study., Place and Duration of Study: Dr. Sami Ulus, Maternity and Child Health, Training and Research Hospital, Ankara, Turkey, between September 2019 and March 2020., Methodology: Sixty-seven patients, who were followed up with a diagnosis of IMDs in the pediatric metabolism outpatient clinic, and 41 healthy volunteers who applied to the social pediatrics outpatient clinic, were evaluated. ​Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios of the patient and control group were calculated. P <0.05 (*) value was considered significant in statistical analysis., Results: The mean native thiol / total thiol ratio of the patient group was significantly lower when compared to the control group (92.0±3.3 vs 94.1±2.7, p=0.001). The median disulfide level [19.8 (11.6-25) vs 14(10.1-18.8), p=0.004], the mean disulfide / native thiol (4.5±2.0 vs 3.2±1.6, p<0.001) and the mean disulfide / total thiol ratios (4.0±1.7 vs 2.9±1.4, p=0.001) were higher in the patient group compared to the control group.The findings showed that oxidative stress status was increased during metabolic attacks. Poor metabolic control and non-compliance to treatment was found to be associated with increased oxidative stress. Oxidative stress parameters were found to be correlated with metabolic chemicals such as ammonia, leucine, and citrulline. There was no correlation between phenylalanine and lactate levels and oxidative stress parameters., Conclusion:  Metabolic control status and compliance with treatment are related to oxidative stress level, showing thiol/disulfide balance in urea cycle defects, phenylketonuria, and galactosemia patients. Key Words: Thiol / disulfide, Metabolic diseases, MSUD, Galactosemia, Hyperammonemia.

Background: This study aimed to evaluate thiol disulphide volume for the risk of contrast-induced nephropathy ( CIN) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI)., Methods: A total of 638 patients with ACS were enrolled in the study. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 h after the procedure. Patients were divided into two groups: patients with and without CIN. Demographics, clinical risk factors, angiographic and laboratory parameters, CIN incidence, thiol, disulphide, and CHA2DS2-VASc score were compared between the two groups., Results: Native thiol, total thiol, and disulphide at baseline were significantly lower in patients who developed CIN compared to those who did not. Also, the CHA2DS2-VASc score was found to be higher in patients with CIN than those without CIN. In receiver operating characteristic analysis showed that at a cutoff of <342.1, the value of native thiol exhibited 82% sensitivity and 80% specificity for detecting CIN. Total thiol< 383.1 calculated on admission had an 80% sensitivity and 80% specificity in predicting CIN., Conclusion: Our study suggested that the thiol disulphide volume on admission was independently associated with the development of CIN after PCI in patients with ACS.

Thiol-disulphide homeostasis (TDH) is a new parameter indicating oxidative stress that plays a role in the pathogenesis of various clinical disorders. Our study planned to investigate TDH in COVID-19 patients. Age and gender-matched healthy subjects (n = 70) and COVID-19 patients (n = 144) were included in the study. In addition to the routine laboratory parameters of the groups, their native thiol (NT), total thiol (TT) and disulphide levels were measured. Primarily, we compared COVID-19 patients to the healthy control group for inflammatory parameters, NT, TT and disulphide levels. Then, COVID-19 patients were divided into two groups according to the severity of the disease as mild to moderate and severe COVID-19, and the three groups were compared with each other. Predictive value of thiol parameters in the diagnosis of COVID-19 and in the determining its severity, and its correlation with presence and duration of symptoms were investigated. Severe COVID-19 patients had lower NT and TT levels compared with healthy controls and mild to moderate patients (P < 0.001 for both). The results of ROC analysis show that the greatest AUC was IL-6 and NT (AUC = 0.97, AUC = 0.96, respectively) between control and COVID-19 patients, while it was CRP and NT (AUC = 0.85, AUC = 0.83) between mild to moderate and severe patients. A negative correlation was found between duration of symptoms of dyspnoea, cough, fever, and sore throat and NT (r = -0.45, P = 0.017, r = -0.418, P < 0.001, r = -0.131, P = 0.084, r = -0.452, P = 0.040, respectively). NT and TT levels have a strong predictive value in the diagnosis of COVID-19 and in determining disease severity. Our results support that changing TDH parameters appears to have an important role in disease pathogenesis and it can be used in clinical management of patients., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: We aimed to evaluate the oxidative stress by measuring the thiol-disulfide balance in women who use either T380A or LNG-IUD as a contraceptive method. Material and method: The study included two groups; 30 women with LNG-IUD and 30 women with copper-IUD. Thiol-disulfide homeostasis as a marker of oxidative stress was analyzed before the IUD insertion and on the 6 th month after insertion. Results: The LNG-IUD group had similar native thiol levels with Cu-IUD (293.1 ± 43.5 µmol/l vs. 290.4 ± 42.4 µmol/l respectively, p  = 819). In the copper-IUD group total thiol levels were higher than LNG-IUD group (345.5 ± 58.2 µmol/l vs. 319.5 ± 52.4 µmol/l, p  = .031). A significant increase was observed after 6 months in LNG-IUD patients in terms of disulfide/native thiol (7.9 ± 4.4% vs. 11.2 ± 2.6%, p  = .006), disulfide/total thiol (6.2 ± 1.8% vs. 8.7 ± 1.9%, p  = .004) and Native thiol/total thiol (87.1 ± 12.1% vs. 82.3 ± 8.2%, p  = .004) levels. After 6 months in copper-IUD patients, disulfide (22.3 ± 7.3 µmol/l vs. 27.5 ± 6.9 µmol/l respectively, p  = .006), disulfide/native thiol (7.7 ± 3.8% vs. 9.8 ± 2.4% respectively, p  = .007), disulfide/total thiol (6.4 ± 2.03% vs. 8.2 ± 1.8% respectively, p  = .007) and native thiol/total thiol (86.3 ± 9.4% vs. 83.8 ± 10.6% respectively, p  = .007) levels were increased. Conclusion: An increase in oxidative stress markers were observed in both groups. Studies evaluating the long term subclinical risks of IUD's are needed to understand the outcomes of the increased oxidative stress.

Objective: To investigate the efficacy of first-trimester thiol/disulfide homeostasis (t/dh), a new oxidative stress marker, in predicting preeclampsia., Study Design: Prospective cohort study., Place and Duration of Study: Department of Obstetrics and Gynecology, University of Health Sciences, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Istanbul, Turkey, Department of Obstetrics and Gynecology, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey, from March 2016 to February 2019., Methodology: In this multi-centre,serum samples of women with839 singleton pregnancies were collected between 11+0 to 13+6gestational weeks. A total of 215 singleton pregnant women were included in the study. The patient group consisted of 38 women, who were diagnosed with preeclampsia; while the control group consisted of 177 healthy pregnant women without any complication during pregnancy and after delivery. Totalthiol (TT) was estimated by the sum of existing thiol groups and reduced thiol groups (S-S and -SH). After the native thiols (-SH) and (TT) were determined, the disulfide (-SS) amounts, disulfide/total thiol percent ratios (-SS/-SH + -SS), disulfide/native thiol percent ratios (-SS/-SH), and native thiol/total thiol percent ratios (-SH/-SH + -SS) were calculated., Results: There were no statistically significant differences between the groups in terms of[(-SH), (TT), (-SS), (-SS/-SH), (-SS/-SH + -SS), and (-SH/-SH + -SS)] six t/dh variables(p>0.05).The first-trimester body mass index (BMI) was statistically different between the two groups (p<0.001). In the receiver operating characteristic curve analysis, none of the concentrations of thiol levels and ratios was found to have a significant predictive value for preeclampsia. The BMI was a significant predictor for preeclampsia (area under curve: 0.749, p<0.001)., Conclusion: Maternal serum t/dh at 11+0 to 13+6 weeks of gestation does not predict preeclampsia and t/dh may be the consequence rather than a cause in the pathogenesis of preeclampsia. Key Words: First-trimester, Preeclampsia, Sulfhydrylcompounds, Thiols.

Objective: In the present study, we aimed to differentiate between transudative and exudative pleural effusions using thiol sulphide homoeostasis, an oxidative stress marker., Design: This was a prospective study., Setting: Emergency Department of Ankara City Hospital, between 1 January 2020 and 15 May 2020., Subjects: Patients who were diagnosed with pleural effusion and underwent thoracentesis to make a differentiation between transudative and exudative pleural effusions. The patients were divided into two groups as those who have transudative pleural effusion and those who have exudative pleural effusion. These two groups were assessed with respect to demographic features and oxidative stress parameters., Main Outcome Measures: Oxidative stress parameters (The native thiol (NT), total thiol (TT), and disulphide (D) levels and their ratios to one another were calculated (index 1: D/NT, index 2:D/TT, index 3: NT/TT)., Results: This study enrolled a total of 50 patients with pleural effusion. Twenty patients (40%) were men, and 30 patients (60%) were women. In the transudative pleural effusion group, 14 patients (56%) had decompensated heart failure, 9 patients (36%) had hepatic cirrhosis, and 2 patients (8%) had hypoalbuminemia. In the exudative pleural effusion group, 17 patients (68%) had malignancy, 7 patients (28%) had parapneumonic effusion, and 1 patient (4%) had pulmonary embolism. TT (P < .001) and NT (P = .001) values were significantly lower in the transudative pleural effusion group compared with the exudative pleural effusion group whereas there was no significant difference between the two groups with respect to D (P = .489), index 1 (P = .07), index 2 (P = .064), and index 3 (P = .063) values., Conclusion: We believe that a differentiation can be made between transudative and exudative pleural fluids by using thiol sulphide homoeostasis, an oxidative stress marker., (© 2021 John Wiley & Sons Ltd.)

Objectives: Restless legs syndrome (RLS) is a common neurological condition. Oxidative stress plays an important role in its pathogenesis. Thiol-disulphide homeostasis (TDH) is a new biomarker of oxidative stress. We studied plasma TDH to determine whether TDH could be used as a new biomarker for RLS and evaluated correlations between TDH and various disease severity rating scales., Methods: A total of 25 RLS patients and 25 healthy controls were included into the study. TDH status was determined using an automated spectrophotometric analysis method and correlations were analyzed between the TDH status and various disease rating scales in the RLS patients., Results: Plasma total (401±27 μmol/L) and native thiol (354±30 μmol/L) levels were significantly lower, but disulphide level (24±6 μmol/L) was significantly (<0.0001) higher in the RLS patients compared to the controls (455±36, 424±37, 15±5 μmol/L, respectively). The disulphide/native thiol and disulphide/total thiol ratios increased, in contrast, native thiol/total thiol ratio decreased significantly in the RLS patients compared to the healthy controls (<0.0001). The disulphide levels correlated positively with age and various rating scores of the RLS patients. International Restless Legs Syndrome Study Group (IRLSSG) rating score and age correlated negatively with the total and native thiol levels., Conclusions: Our findings indicate increased oxidative stress in the RLS patients reflected by decreased native and total thiol, and increased disulphide levels and positive correlations between the disulphide levels and various rating scores. We suggest dynamic TDH status to be used as a novel biomarker for the diagnosis and follow-up of the RLS patients., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: It is possible that patients with pneumonia may also have sepsis and the separation of these two clinical entities may cause some trouble to clinicians., Objective: In order to separate a patient with pneumonia and a patient with sepsis, we qualify thiol/disulfide homeostasis as a potential biomarker., Methods: This study was designed between February 2018 - February 2019 prospectively. All patients in the intensive care unit with pneumonia and sepsis were enrolled in the study. At the time of hospitalization, thiol/disulfide homeostasis was measured. Patients diagnosed with sepsis and pneumonia were compared, in regards to thiol/disulfide homeostasis., Results: During research period, 103 patients with sepsis and 120 patients with pneumonia were enrolled into the study. When we compared native-thiol, total-thiol, and disulfide levels in both sepsis and pneumonia patients, we had similar results (p>0.05). In sepsis group, index-1 (disulfide/native thiol ratio) and index-2 (disulfide/total thiol ratio) were found to be statistically higher than the pneumonia group, and index-3 (native thiol/total thiol ratio) was statistically lower than the pneumonia group (p=0.020, p= 0.021, p=0.021, respectively)., Conclusion: In this study, we showed that thiol/disulfide homeostasis could be used as new markers in the early period in order to separate patients with sepsis and patients with pneumonia., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aim: Obstructive sleep apnea syndrome (OSAS) is a chronic and incapacitating disease that often requires lifelong care. This study aimed to evaluate the thiol/disulfide homeostasis in patients with OSAS, to compare the thiol/disulfide levels with the control group and to investigate their relationship with the severity of the disease., Material and Methods: Patients who were admitted to the department of chest diseases, and diagnosed with OSAS using polysomnographic analysis ( n  = 186) and 144 patients who underwent polysomnography due to some reasons but ruled out of having OSAS were included in the study. Serum total thiol (TT), native thiol (SH), and disulfide thiol (SS) levels were measured from the participants; SS/SH, SS/TT, and SH/TT percent ratios were calculated and compared between the patient and control groups., Results: The mean (±SD) age of the patients and control participants was 52.0 ± 11.5 years and 44.9 ± 13.2 years, respectively. Compared to the control group, patients with OSAS had significantly lower SH (239.3 ± 56.3 μmol/L vs . 258.6 ± 65.3μmol/L, t  = 2.70, p =.007) and TT levels (273.2 ± 60.1 μmol/L vs . 292.9 ± 67.5μmol/L, t  = 2.64, p =.010). Age (OR = 1.04), serum albumin (OR = 12.67), ischemia-modified albumin (IMA) (OR = 0.12), SH (OR = 0.81), and TT (OR = 1.17) were independent predictors of OSAS., Conclusions: These results support the idea that decreased ST and TT levels are related to increased oxidative stress. On the other hand, impaired thiol balance may play a significant role in the pathogenesis of OSAS.

Atopic dermatitis (AD) is a chronic disease of infancy and its pathogenesis remains unclear. There are recent studies suggesting that oxidative stress could play a role in the pathophysiology of atopic dermatitis. The aim of this study was to evaluate thiol (SH)-disulfide (SS) hemostasis as a new marker of oxidative stress (OS) in infants with atopic dermatitis. Thirty-one infants with AD and 30 healthy infants were included in a prospective, cross-sectional study. PO-SCORAD Index of infants with atopic dermatitis was calculated at the time of sample collection. Total antioxidant status (TAS), total oxidant status (TOS), native thiol (-SH), total thiol (-SH + -S-S-), and disulfide (SS) were measured in the control and patient groups. SS/SH, SS/total SH, SH/total SH ratios were compared between the groups. Mean native thiol and total thiol concentrations of the patient group were lower than the control group (p = 0.012; 0.047). The mean disulfide concentration of the patient group was significantly higher than the control group (p = 0.025). SS/SH, SS/total SH, and SH/total SH ratios were significantly higher in the patient group than in the control group (p < 0.05). There was a positive correlation between the duration of the breasting of the patients and thiol concentrations (p = 0.000). In our study, we found increased oxidative stress and decreased antioxidant defense mechanisms in infants with AD. Dynamic thiol-disulfide balance in the patient group was weakened and the balance shifted towards the oxidative side. These results may shed light on etiopathogenesis of atopic dermatitis and be useful in the development of new therapeutic methods.

Background: Thiol/disulfide (SH/SS) homeostasis plays an essential and dynamic role in our body and in various cellular activities and pathways such as cell death, regulation of enzyme activities, mechanisms of transcription and cellular signal transduction. Lung cancer is the most commonly seen cancer type in the adult population. Therefore, prediction of metastases gains importance in this population., Methods: We included 150 patients with lung cancer who attended Kirikkale University Medical Faculty Hospital between June 2017 and June 2018. Our purpose was to evaluate whether metastases can be predicted in lung cancer patients by testing SH/SS homeostasis as a novel and easily applicable biochemical test., Results: The mean age of the patients was 63.8 ± 8.1 (41 - 71) years. Advanced stage lung cancer, adenocarcinoma, squamous-cell and small cell lung cancers, and other types were detected in 54.7%, 42.7%, 41.3%, 13.3%, and 2.7% of the patients, respectively. SS values of the patients with advanced stage lung cancer were higher than in patients with early stage lung cancer (p < 0.001). It was determined that the patients with advanced stage lung cancer had statistically significantly higher mean values of SS, SS/SH (%), and SS/total SH (%) than patients with early stage lung cancer and that a statistically significantly lower mean value of SH/total SH (%) was found in advanced stage compared with early stage lung cancer patients. No statistically significant difference was found between the patient groups with advanced and early stage lung cancer regarding mean values of native SH and total SH levels., Conclusions: It can be concluded that SH/SS parameters may vary in advanced and early stage lung cancer patients; however, further studies should be conducted with SH/SS parameters in order to use them as indicators of cancer severity in lung cancer patients.

Purpose: The aim of this study was to evaluate thiol/disulfide homeostasis and ischemia-modified albumin levels with primary open-angle glaucoma, ocular hypertension, and control group; also to interpret the correlation between these biochemical parameters and retinal nerve fiber layer analysis., Material and Methods: In a prospective cross-sectional study, 30 primary open-angle glaucoma cases, 30 ocular hypertension cases, and 30 control subjects were included in the study. Native thiol, total thiol, and disulfide measurements and disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were evaluated as thiol-disulfide homeostasis. Albumin and ischemia-modified albumin parameters were also evaluated. All cases underwent detailed ophthalmologic examination including visual acuity, retinal nerve fiber layer via optical coherence tomography, intraocular pressure, and central corneal thickness measurements and visual field analysis by 24-2 Swedish Interactive Threshold Algorithm (SITA) Standard visual field test., Results: Primary open-angle glaucoma group had significantly higher ischemia-modified albumin values than ocular hypertension and control group (p < 0.001). Native thiol and total thiol values of control group were statistically higher than those of primary open-angle glaucoma and ocular hypertension groups. The correlation between the temporal retinal nerve fiber layer value and ischemia-modified albumin, disulfide/native thiol, and disulfide/total thiol values of the primary open-angle glaucoma patients included in the study was moderate correlation in negative direction (r = -0.46, r = -0.39, r = -0.39, respectively), whereas there was a statistically significant moderate correlation in positive direction between the native thiol/total thiol values (r = 0.39) (p < 0.05)., Conclusion: These findings have reinforced the role of oxidative stress in the etiopathogenesis of primary open-angle glaucoma, suggesting that the thinning retinal nerve fiber layer may be associated with oxidative stress in favor of prooxidant shift.

Objective: To determine the effects of subclinical hypothyroidism on oxidative stress in children., Study Design: A cross-sectional study., Place and Duration of Study: Department of Paediatrics, Paediatric Endocrinology, and General Outpatient Clinics, Kirikkale University, School of Medicine, from May 2017 to October 2018., Methodology: This study included 92 subjects aged between 2 and 18 years. The subjects were divided into two groups. Forty-seven children with subclinical hypothyroidism and 45 healthy controls were evaluated. In order to evaluate oxidative damage, native thiol, total thiol, disulfides, their ratios, and ischemia-modified albumin (IMA) levels were compared between the two groups. The relationship between TSH and IMA levels was assessed., Results: Age and gender were not significantly different in the two groups. Native thiol, total thiol, disulfides and their ratios were similar in the two groups. Ischemia-modified albumin levels were significantly higher in the patient group than the controls (p<0.001). There was no correlation between TSH and IMA levels in the patient group (r=0.069 p=0.645)., Conclusion: Subclinical hypothyroidism may be related to the impairment of IMA, and have a neutral effect on thiol/disulfide balance. Further research is needed to explain the effects of oxidative stress in subclinical hypothyroidism. Key Words: Subclinical hypothyroidism, Childhood, Oxidative stress.

Aim: The objective of this study was to examine the thiol-disulfide profile tests in patients suffering from burn injuries., Methods: This case-control study comprised 48 patients with thermal burn injuries and 61 healthy individuals. Thiol-disulfide tests were conducted in both groups, and also, the changes of thiol-disulfide parameters were analyzed at zero time and on days 3, 7, 15, and 30 of the admission in patients with burn injuries., Results: The patients had significantly decreased native and total thiol levels and native thiol/total thiol ratios, and significantly increased disulfide/native thiol and disulfide/total thiol ratios compared to control individuals (p<0.001 for all). The variations of native thiol levels, total thiol levels, and disulfide/native thiol ratios were significantly different over time in patients with burn injuries (p<0.001, p<0.001, p<0.05, respectively). There were strong associations with the clinical parameters and thiol-disulfide profile tests (p<0.05 for all)., Conclusion: There was a metabolic disturbance of the thiol-disulfide system among patients with burn injuries. The courses of thiol-disulfide variables in time overlapped with the burn mechanism. Strong associations provide that thiol-disulfide homeostasis might be a notable key for evaluating the severity of burns and predicting the survival., (Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.)

Purpose: To evaluate the ability of thiol-disulphide homeostasis to predict renal injury in ureteral obstruction by matching renal scintigraphy and pathological findings in an experimental rat model., Methods: 24 rats were randomized and divided into 3 groups as sham, partial and complete. Blood samples for biochemical evaluations and dimercaptosuccinic acid (DMSA) renal scintigraphy were performed at the beginning and on the 7th day postoperatively. Only a midline abdominal incision was done in sham group. Left ureter of partial group was dissected and gently buried into the psoas muscle. In complete group, left ureter was dissected and ligated., Results: Statistically significant association was found between left kidney function loss percentage, native thiol, total thiol and creatinine alterations and pathological EGTI (Endothelial, Glomerular, Tubular, Interstitial) scores (r = - 0.867, r = - 0.815, r = 0.745, r = - 0.911; p = 0.000). Statistically significant difference was detected between groups in terms of postoperative native thiol and total thiol values (p = 0.000, p = 0.001). There was also a significant difference in preoperative and postoperative comparisons of these parameters in partial and complete obstruction groups (p = 0.012, p = 0.018). There was a significant difference in terms of postoperative disulphide/native thiol and native thiol/total thiol ratios in complete obstruction group compared to other groups (p 1  = 0.011, p 2  = 0.040; p 1  = 0.015, p 2  = 0.028)., Conclusions: Association with scintigraphic and pathological results empowers the value of this parameter. Disulphide/native thiol and native thiol/total thiol ratios indicate complete obstruction. These findings may shed light to more comprehensive studies.

Background: This study aims to investigate the role of thiol/disulfide homeostasis parameters in the diagnosis of acute appendicitis and to determine whether it is beneficial to use these parameters in combination with the modified Alvarado and RIPASA scoring systems., Methods: This study was prospectively carried out on 265 patients who presented to the emergency department with the complaint of right lower quadrant pain between 01.07.2017 and 31.12.2017, and met the inclusion criteria of this study. Oxidative stress markers were evaluated on two groups. The relationship between these parameters and the modified Alvarado and RIPASA scoring systems was analyzed., Results: The mean levels of disulfide, disulfide/native thiol and disulfide/total thiol were found to be significantly higher in the appendicitis group (p<0.001). The mean levels of native thiol, total thiol and native thiol/total thiol were significantly lower in the same group (p<0.001, 0.001 and 0.007, respectively). The mean levels of disulfide, disulfide/native thiol and disulfide/total thiol were recorded to be significantly higher in the high-risk group according to the results of RIPASA (p=0.016, 0.003 and 0.001, respectively)., Conclusion: Thiol/disulfide homeostasis parameters can be used with the modified Alvarado and RIPASA scoring systems in the diagnosis of acute appendicitis.

Introduction : We aimed to investigate serum dynamic thiol and disulfide levels in patients with molar pregnancy (MP), and compare these concentrations with those of healthy pregnant women. Materials and Methods: Forty-one patients who were diagnosed with MP and 41 gestational age-matched healthy pregnant women were included in this prospective study. MP cases were separated in two groups as complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM). Demographic features and thiol/disulfide homeostasis were recorded for each woman. Results: There was a significant correlation between the decrease in the total thiol and native thiol levels in MP patients. However, no significant difference was observed between CHM and PHM groups in terms of serum disulfide levels. Conclusion: OS is increased in MPs both in complete and partial moles, as determined by thiol/disulfide analysis.

Aim: The main aim of this study was to investigate thiol/disulfide homeostasis associated with fetal growth restriction (FGR) and to evaluate whether alterations are predictive for adverse neonatal outcomes. Methods: 273 pregnant women (77 with FGR and 196 with normal fetal growth) were enrolled in this prospective case-control study. Results: Native thiol and total thiol were decreased in FGR compared to the control group ( p  < .001; p  < .001). Decreased levels of maternal serum native and total thiol were significantly associated with adverse neonatal outcomes in FGR (OR: 0.983, 95% CI 0.976-0.991, p  < .001; OR: 0.983, 95% CI 0.976-0.991, p  < .001). Decreased maternal serum total thiol levels were the only significantly associated risk factor with adverse neonatal outcomes in FGR (OR: 0.981, 95% CI 0.963-1.000, p  = .046). Conclusion: The decrease in the antioxidants of thiol/disulfide mechanism may be related to the development of both FGR and adverse neonatal outcome in FGR.

Aim: The purpose of this study was to examine thiol-disulfide balance in patients with type 2 diabetes mellitus., Methods: This study included 32 subjects with known type 2 diabetes mellitus without complications, 30 patients with type 2 diabetes mellitus with complications, 28 newly diagnosed patients with type 2 diabetes mellitus, and 45 healthy individuals. Thiol-disulfide profile tests were quantified in all groups., Results: Compared to the control group, patients in each of the diabetic groups had significantly lower native and total thiol levels, higher disulfide levels, and higher disulfide/native thiol and disulfide/total thiol ratios ( p <0.05 for all). Disulfide levels were significantly lower in the newly diagnosed group than in other diabetic groups ( p <0.05). There were significant associations between glycemic parameters and thiol-disulfide tests ( p <0.05)., Conclusions: A disequilibrium between thiol-disulfide pairs occurs in patients with type 2 diabetes mellitus, and a gradual increase to disulfide levels may contribute to the disease's severity. Deteriorated thiol-disulfide homeostasis may be relevant to the pathophysiology of type 2 diabetes mellitus., Competing Interests: The authors declare that they have no conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Acute pancreatitis is a common disease seen in emergency departments because of abdominal pain. The present study aims to evaluate the relation between measurements of thiol-disulfide parameters in patients diagnosed with acute pancreatitis and other blood parameters., Methods: A total of 56 (56%) patients, who were admitted to the emergency department, and 44 (44%) healthy volunteers participated in this study. A total of 100 samples were taken from the participants. Detailed blood samples were taken from the patients at the time of arrival at the hospital. The thiol-disulfide level in serum was examined using a brand new method that was developed by Erel and Neşelioğlu in the venous blood samples of the patients who were diagnosed with acute pancreatitis during the admission. The data were evaluated in the computer medium., Results: Gallstones were defined as the etiology of AP in 41 patients (73.2%); in one patient, hypertriglyceridemia (1.7%); in four patients, alcohol use (7.1%), and idiopathic 10 patients (17.8%). While the blood thiol levels were low, the disulfide levels were high at a significant level. No statistically significant relations were detected between the amylase, lipase, neutrophil lymphocyte ratio (NLR), which are other blood parameters, and thiol-disulfide balance parameters., Conclusion: The disruption of the thiol-disulfide balance may play a role in the pathogenesis of acute pancreatitis. In acute pancreatitis, since the thiol level is decreased in the blood, administration of the complementary therapies for this thiol deficiency may contribute to the treatment of the disease.

We studied dynamic thiol/disulphide homeostasis, an indicator of oxidative stress, to investigate the effects of newly initiated exercise training on sedentary obese adults. Seventeen sedentary obese adults and 15 normal-weight controls were included in the sample for this study. The obese adults were given a physical exercise training program that lasted twelve weeks. Before and after the exercise training program, blood samples were collected, and serum thiol/disulphide parameters were measured by using a novel technique. Before the start of the exercise training, it was observed that thiol/disulphide homeostasis was impaired, and this impairment was positively correlated with body mass index in sedentary obese adults because of the higher reactive oxygen species production in adipose tissue. However, while the obese participants' body mass index significantly decreased, the thiol/disulphide homeostasis parameters in the obese adults did not change over time as calculated at the baseline and compared to the calculation after the twelve weeks of exercise training. Despite a decrease in body mass index that occurred after the twelve weeks of exercise training, there was a lack of improvement in the obesity-induced impairment of thiol/disulphide homeostasis, which suggests that a newly initiated exercise training program may lead to oxidative stress.

Objective: We searched thiol/disulphide homeostasis and ischemia modified albumin (IMA) in patients with and without endometrial polyp (EP) to evaluate whether there is an association between serum oxidative stress markers and EPs., Methods: A total of 87 women were enrolled into this study. All patients were evaluated with office hysteroscopy, and then those with EPs underwent operative hysteroscopy. 43 of these women had pathologically confirmed EPs (study group) and 44 had not (control group). Fasting blood samples were obtained from the antecubital vein before the procedure in all women. Thiol/disulphide levels were analyzed with a newly developed method by Erel et al. IMA measurement was performed using an indirect method based on the colorimetric assay as previously defined., Results: There were no significant differences between the 2 groups in terms of demographic characteristics including age, body mass index, and past obstetric history. Similarly no significant difference was observed regarding infertility ratio and smoking status. Native thiol, total thiol, and disulphide levels were found to be 263.6±63.3 µmol/l vs. 280.9±63.8 µmol/l (p:0.208), 296.9±64.9 µmol/l vs. 315.2±67.3 µmol/l (p:0.202), and 16.6±6.5 µmol/l vs.17.1±7.8 µmol/l ( p:0.759) in the study and control groups, respectively. There was also no significant difference with regard to serum IMA level (46.5±12.1 vs. 44.9±12.6; p: 0.539)., Conclusion: Serum thiol/disulphide homeostasis and IMA levels have no significant effect in the pathogenesis of EPs., (© 2019 Old City Publishing, Inc.)

Aim: The aim is to compare the markers of oxidative stress in iron deficient children to that of non-anemic children. Method: Serum thiol-disulfide level, ferroxidase activity and ischemia-modified albumin (IMA) levels were compared between iron deficiency anemia (IDA) and non-anemic children. Results: A total of 117 children, 66 with IDA and 51 non-anemic children were included in the study. Disulfide, disulfide/native thiol, and disulfide/total thiol levels were significantly higher in the IDA group ( p : 0.001). Serum ferroxidase levels were significantly lower in the IDA group ( p : 0.04); but there was no significant difference between the two groups regarding serum IMA levels ( p : 0.42). There was a weak negative correlation between disulfide and serum hemoglobin ( p : 0.004), iron ( p : 0.041), and ferritin ( p : 0.023) levels while there was a weak positive correlation between ferroxidase activity and these parameters. Conclusion: There is an increased protein oxidation in children with IDA compared with non-anemic controls.

Background: Thiols are organic compounds consisting of a sulfhydryl group which exerts antioxidant effects via dynamic thiol-disulfide homeostasis (TDH). The shift towards the disulfide states signals an oxidative situation. Maternal-neonatal oxidative stress can be affected by the anesthetic technique used during cesarean section. This study aimed to evaluate the relationship between the type of anesthesia used and the maternal-neonatal TDH., Methods: ASA I-II, term parturients undergoing elective cesarean section either under general (Group G) or spinal (Group S) anesthesia were included. Blood specimens were collected preoperatively and postoperatively from the mothers and from the umbilical venous cords at delivery. TDH was studied by a new method developed by the authors (O.E. and S.N.)., Results: Postoperative mother's native thiol, total thiol, disulfide/total thiol, native thiol/ disulfide and disulfide levels were higher in Group G than in Group S. There was no significant difference between the groups in umbilical venous cord albumin, native thiol/total thiol, disulfide, native thiol/ disulfide and total thiol/ disulfide. However, in Group G, umbilical venous cord native thiol and total thiol levels were statistically significantly lower than those in Group S., Conclusions: Our results showed that general anesthesia in cesarean section leads to an impairment in TDH when compared with spinal anesthesia. Oxidative stress might be modified by the preferred anesthetic technique.

Purpose : To evaluate thiol-disulfide homeostasis (TDH) and its relationship with clinical findings in patients with Graves' ophthalmopathy (GO). Methods : This study included 52 patients with GO and 34 healthy controls. Tests of TDH were conducted using the novel automated spectrophotometric method. Clinical activity score (CAS) and ophthalmopathy index were evaluated and relationships with native thiol, disulfide levels and disulfide/native thiol % ratios were analyzed. Results : The mean plasma native thiol levels in GO patients were significantly lower than that of normal controls ( p = 0.013) . The mean plasma disulfide levels and disulfide/native thiol % ratio were found to be significantly higher in GO patients than in controls ( p = 0.041, p = 0.022; respectively). The mean native thiol levels of active GO patients ( n = 24) were significantly lower than that of patients with inactive GO ( n = 28) ( p = 0.044). The mean disulfide levels and disulfide/native thiol % ratios of active GO patients were significantly higher than that of patients with inactive GO ( p = 0.034, p = 0.001; respectively). There was a negative correlation between native thiol and CAS ( r = -0.532, p = 0.001) and a positive correlation between disulfide/native thiol % ratio and CAS ( r = 0.601, p < 0.001). Conclusions : The impairment of TDH indicates the presence of oxidative stress in moderate-to-severe GO, particularly in active GO and smokers.

Oxidative stress plays an important role in the development of infertility secondary to varicocele. We aimed to investigate the dynamic thiol-disulphide homeostasis as an oxidative stress marker in the spermatic vein of infertility secondary to varicocele. Sixty-one patients with varicocele were included in the study. Blood was drawn from the median cubital vein and the testicular venous return side before the spermatic vein was separated during surgery. Total thiol, native thiol, disulphide, ischaemia modified albumin (IMA) and albumin values were measured from both the dilated spermatic vein and the median cubital vein. The disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were determined. The mean age of the patients was 27.0 ± 6.68 (15-50) years. While the albumin, native thiol and total thiol values and the native thiol/total thiol ratio were significantly lower (p = 0.004, p < 0.001, p < 0.001, p < 0.001 respectively), the IMA value and the disulphide/native thiol and disulphide/total thiol ratios were significantly higher (p < 0.001, p < 0.001, p < 0.001 respectively) in the samples taken from spermatic venous blood. Thiol-disulphide balance had deteriorated towards disulphide formation in the spermatic vein compared with the peripheral vein. Abnormal thiol-disulphide balance may be an independent risk factor for infertility secondary to varicocele., (© 2019 Blackwell Verlag GmbH.)

Objective: To determinate the effects of bilirubin and phototherapy on oxidative stress in newborns., Study Design: A case-control study., Place and Duration of Study: Third level Newborn Intensive Care Unit, Ankara Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Turkey, from May to August 2017., Methodology: Blood samples of 62 term newborns were grouped as control, before and after phototherapy. Total and native thiol, disulfide and ischemia modified albumin values in expressed blood samples were measured. Disulfide-native thiol ratio, disulfide-total thiol ratio and native thiol-total thiol ratio values were computed., Results: Bilirubin levels were positively correlated with native and total thiol levels and negatively correlated with ischemia modified albumin levels (r=0.409 p= 0.001, r= 0.328 p<0.009, r=-0.503 p<0.001). Native and total thiol levels of the control group were lower (p<0.001) and ischemia modified albumin levels were higher than those before and after phototherapy (p<0.001). In jaundiced newborns, native and total thiol values reduced after phototherapy, while IMA levels increased (p=0.001, p<0.001, p<0.001)., Conclusion: Bilirubin showed antioxidant effect without increasing oxidative stress. Oxidative stress increased after phototherapy. This result was associated with decrease in bilirubin rather than oxidative effect of phototherapy.

Objective: To investigate the effect of continuous lung ventilation with low tidal volume on oxidation parameters, such as thiol/disulphide homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG)., Methods: Seventy-four patients who underwent elective CABG with CPB were included in the study. Blood samples were taken in the preoperative period, 10 minutes after CPB, and six and 24 hours postoperatively. Patients were assigned to the continuous ventilation group (Group 1, n=37) and the non-ventilated group (Group 2, n=37). The clinical characteristics, thiol/disulphide homeostasis, ischemia-modified albumin (IMA), and AAIMA levels of the patients were compared., Results: A significant difference was found between the groups regarding native thiol, total thiol, and IMA levels at the postoperative 24th hour (P=0.030, P=0.031, and P=0.004, respectively). There was no difference between the groups in terms of AAIMA. AAIMA levels returned to preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative hours, respectively. Length of hospital stay was significantly shorter in Group 1 (P<0.001) than in Group 2., Conclusion: Continuous ventilation during CPB caused an increase in native and total thiol levels, an earlier return of AAIMA levels, and shorter hospital stay. Continuous ventilation may reduce the negative effects of CPB on myocardium (Table 2, Figure 1, and Reference 31).

Aim : Glaucoma is an optic neuropathy causing progressive impairment of visual functions. We aimed to assess the alterations in thiol-disulfide homeostasis and serum ischemia modified albumin (IMA) levels, which are the determinants of antioxidant status, in patients with primary open-angle glaucoma (POAG). Material and Method : A total of 140 eyes from 70 patients with POAG and 174 eyes of 87 healthy, control cases were included in the study. All study participants underwent a complete ophthalmic evaluation. Alterations in serum thiol-disulfide homeostasis and IMA levels were measured in all participants. Results : IMA levels were significantly higher in glaucoma group (p:0.001). Native thiol, Total thiol and Native/Total thiol ratio were significantly decreased while Disulfide, Disulfide/Native thiol, and Disulfide/Total thiol ratios were significantly higher in glaucoma group (p:0.001). There was no significant difference regarding central corneal thickness (CCT), iridocorneal angle, albumin, IMA and adjusted IMA levels in patients with different stages of glaucoma. In correlation analysis, there was a negative correlation between Native thiol, Total thiol and Native/Total thiol ratio and disease period, number of daily drops required and stage of the disease in glaucoma patients. There was also a positive correlation between Disulfide, Disulfide/Native thiol and Disulfide/Total thiol levels and the disease activity. Conclusion : In patients with POAG, thiol-disulfide homeostasis is disturbed in the favor of pro-oxidant molecules and IMA levels are increased, indicating the presence of augmented oxidative stress. In that aspect, systemic and local anti-oxidant treatments may be new targets in glaucoma treatment. Larger, prospective studies about the role of anti-oxidants in prevention and treatment of POAG are warranted.

Purpose: A dynamic thiol/disulfide balance is pivotal in organizing anti-oxidant defense, detoxification, apoptosis, and enzyme activities, as well as transcription and cellular signal-transfer mechanisms. The connection between urolithiasis and oxidant/antioxidant status, which can be assessed through thiol-disulfide homeostasis (TDH), has not yet been examined. In this study, we evaluated the effects of TDH on the formation, size, and location of stones by examining the associations between TDH parameters and urolithiasis., Materials and Methods: Patients with urolithiasis and healthy controls were recruited. The patients were divided into subgroups in terms of stone size (>15 mm or ≤15 mm) and stone location (nephrolithiasis or ureterolithiasis). TDH parameters were measured using a novel automatic and spectrophotometric method and compared statistically., Results: TDH parameters were different between the urolithiasis and control groups. TDH tended towards the disulfide side in the urolithiasis group. Stone size increased an average 0.14 mm with a 1 µmol/L increase in disulfide level and decreased an average 0.058 mm with a 1 µmol/L increase in native thiol level. Disulfide and native thiol levels were found to be different across patients with stone size >15 mm, ≤15 mm, and controls (p<0.001 and p<0.001, respectively). However, the nephrolithiasis and ureterolithiasis groups were similar in respect of TDH parameters., Conclusions: In this study, it was found that patients with urolithiasis displayed oxidative stress characterized by a TDH tendency towards the disulfide side, and an inadequate antioxidant response identified by a lower level of native thiol as compared with healthy controls., Competing Interests: CONFLICTS OF INTEREST: The authors have nothing to disclose.

Background and objectives : The aim of this study was to research oxidative stress and thiol/disulphide homeostasis in Graves' patients. Materials and Methods : The study included 33 Graves' patients (research group) and 35 healthy subjects (control group). Serum oxidative stress and thiol/disulphide homeostasis (a new and automated spectrophotometric method developed by Erel and Neselioglu) parameters were studied and compared between the groups. Results: The native and total thiol levels and the native thiol/total thiol ratio were lower in patients with Graves' disease compared to the control group ( p < 0.001, p < 0.001, and p = 0.006, respectively). TOS (total antioxidant status), PC (protein carbonyl), OSI (Oxidative stress index), and disulphide/native thiol and disulphide/total thiol ratios were determined to be higher in the Graves' disease group than in the control group ( p < 0.001, p = 0.001, p = 0.001, p = 0.004, and p = 0.006, respectively). In the Graves' disease group, the free triiodothyronine (FT3) and free thyroxine (FT4) levels were significantly positively correlated with impaired thiol/disulphide homeostasis and oxidative stress parameters ( p < 0.05). Conclusion : The results of the current study demonstrated that oxidative stress and thiol/disulphide homeostasis increased towards disulphide formation due to thiol oxidation in Graves' disease. In addition, a positive correlation of FT3 and FT4 was observed with oxidative stress parameters and impaired thiol/disulphide homeostasis.

The aim of this study is to evaluate a novel oxidative stress marker (thiol-disulphide homeostasis) in paediatric sepsis and to determine their effects on the prognosis of sepsis. Patients diagnosed with sepsis (n= 38) and healthy controls (n= 40) were incorporated in the study. Total thiol, native thiol, disulphide, disulphide/total thiol, disulphide/native thiol, and native thiol /total thiol levels were measured in the sepsis and control groups. Additionally, the parameters were compared between survivors and non-survivors in the sepsis group. The levels of hemoglobin, white blood cell, platelet, lactate, and C-reactive protein were measured in patients with sepsis at diagnosis. The paediatric risk of mortality and paediatric logistic organ dysfunction scores of the patients were used to estimate the disease severity. The plasma thiol levels of the patients with sepsis were significantly lower than the control group (p < 0.001). This study showed that thiol/disulphide homeostasis is abnormal in children with sepsis in Paediatric Intensive Care Unit., Competing Interests: The authors report no conflicts of interest in this work., (Sociedad Argentina de Pediatría.)

Background: Repetitive episodes of hypoxia and reoxygenation during sleep in patients with obstructive sleep apnea syndrome (OSAS) resemble an ischemia-reperfusion injury. We aimed to test the hypothesis that oxidative stress occurs in pregnant women with OSAS. We also aimed to compare thiol/disulfide homeostasis with ischemia-modified albumin (IMA) and total antioxidant capacity (TAC) as markers of ischemia-reperfusion injury in pregnant women with and without OSAS and healthy control. Methods: This study included 29 pregnant women with OSAS, 30 women without OSAS in the third trimester applying for periodic examinations, and 30 healthy women. Serum IMA and TAC (using the ferric reducing power of plasma method) were measured. Serum thiol/disulfide homeostasis was determined by a novel automated method. Results: The mean age of the pregnant women with OSAS was 31.0 ± 4.7 years with a mean gestational age of 36.5 ± 3.0 weeks. The mean age of pregnant women without OSAS was 29.8 ± 4.9 years with a mean gestational age of 36.9 ± 2.7 weeks. The mean age of the nonpregnant control group was 29.7 ± 6.4 years. Both native thiol (291 ± 29 μmol/L versus 314 ± 30 μmol/L; p  = .018) and total thiol (325 ± 32 versus 350 ± 32, p  = .025) levels were lower in pregnant women with OSAS compared to pregnant women without OSAS, respectively ( p  < .01). Conclusions: This is the first study demonstrating the thiol/disulfide homeostasis in pregnant women with OSAS. Native thiol and total thiol levels were lower in pregnant women with OSAS compared to those without OSAS. However, dynamic thiol/disulfide homeostasis parameters cannot provide valuable information to discriminate OSAS in pregnant women.

Background: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol-disulfide homeostasis. The shift towards disulfides indicates the presence of oxidative environment. Thiol-disulfide homeostasis has not been evaluated in neonates. We aimed to evaluate dynamic thiol-disulfide homeostasis in preterm infants., Methods: Preterm infants with birth weight less than 1500 g (25-32 weeks of gestation) were included. Infants with major congenital anomaly, perinatal asphyxia, twin to twin transfusion and infants who were mechanically ventilated and nil by mouth for more than 3 days or fed with formula, had intraventricular hemorrhage ≥ grade 2 or sepsis, received blood/blood product transfusion or inotrope treatment and developed bronchopulmonary dysplasia or retinopathy of prematurity (≥ stage 3), and died were excluded thereafter. Serum thiol-disulfide homeostasis was evaluated for three times: (Baseline, first week, third week). Serum native thiol, total thiol and disulfide were measured (µmol/Lt), disulfide:native thiol, disulfide:total thiol, and native thiol:total thiol ratios were calculated. Wilcoxon's test was used to analyze the significance of change in measurements. Baseline results were analyzed for gender and mode of delivery., Results: Eighty preterm infants [1255 (1080-1415) grams] were included. Baseline values were native thiol: 209.54 ± 41.83 µmol/L; total thiol: 251.70 ± 45.82 µmol/L; disulfide: 21.08 ± 7.43 µmol/Lt; disulfide:native thiol: 10.49 ± 4.62; disulfide:total thiol: 8.45 ± 2.93; native thiol:total thiol: 83.10 ± 5.87. Thiol levels increased in each measurement, disulfide and disulfide/thiol ratios increased in the first week, decreased in the third week, ratio of native/total thiol decreased in the first week, increased in the third week. No effect of gender or mode of delivery on baseline thiol-disulfide homeostasis was detected., Conclusions: The shift in the thiol-disulfide equilibrium towards disulfides in the first week can be attributed to subjection of infants to many oxidative insults. Furthermore, the thiol predominance in the third week could be explained by the decrease in oxidative events and increase in feeding as a supply of antioxidants. This study, displaying the levels of the dynamic thiol-disulfide homeostasis in preterm infants without obvious risks for increased oxidative stress, may provide acceptable range for thiol-disulfide homeostasis in recovering preterm infants.

Background: Oxidative stress may play an important role in rheumatoid arthritis (RA) etiopathogenesis. The thiol group is a very strong antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with RA by evaluating thiol/disulfide homeostasis., Material and Methods: A total of 50 female RA patients and 50 healthy female controls were included in this study. Thiol and disulfide values were calculated utilizing novel methods., Results: Native thiol (p < 0.001) and total thiol (p < 0.001) levels of RA patients were significantly lower compared to values in the control group. However, the disulfide (p < 0.001) levels of RA patients were strongly higher than in healthy individuals. A negative correlation was found between thiol and disease activity score-28 among the patients, whereas a positive correlation was found between disulfide and disease activity score-28 among the patients., Conclusion: We found that the thiol-disulfide rate deteriorated in RA patients, with the proportion of disulfide increasing. There is a strong correlation between the decrease in thiol levels, increase in disulfide levels and the disease activity scores.