CORRELATION BETWEEN PRE AND POST TREATMENT EFFECT OF METHOTREXATE AND ANTI-OXIDANT STATUS IN RHEUMATOID ARTHRITIS PATIENTS
Main Article Content
Keywords
Rheumatoid Arthritis, Chronic Inflammatory Disorder, Treatment, Pre-treatment, Post-treatment, Management Strategies, Methotrexate, Anti-oxidant
Abstract
Rheumatoid Arthritis (RA) is a chronic inflammatory disorder characterized by oxidative stress and joint damage. This study evaluates the biochemical impact of Methotrexate (MTX) treatment on RA patients, focusing on oxidative stress markers, antioxidant activity, and overall disease management. Analysis of 60 RA patients before and after MTX treatment revealed significant biochemical changes. Post-treatment, Malondialdehyde (MDA), a marker of oxidative stress, was elevated, while Glutathione (GSH) levels increased, indicating some restoration of antioxidant defense. However, catalase and superoxide dismutase (SOD) activities were significantly reduced, reflecting persistent oxidative imbalance. Non-enzymatic antioxidants, including vitamins A, C, and E, showed substantial improvement post-treatment. Elevated Advanced Oxidation Protein Products (AOPP) and reduced nitric oxide (NO) levels post-treatment suggest decreased inflammatory activity. Electrolyte levels, specifically sodium and potassium, were notably altered, indicating potential disruptions in homeostasis. Additionally, increased urea and creatinine levels post-treatment point to potential renal dysfunction. This study underscores Methotrexate's role in modulating oxidative stress and inflammation in RA, highlighting the importance of monitoring biochemical parameters for effective disease management and the need for further research into long-term treatment effects and management strategies.
References
2. Teiji, W., Tomoki, N., Nishina, H., Josef M.P. (2006). RANKL-RANK signaling in osteoclastenogenesis and bone disease. Trends in Molecular Medicine, 12(1), 17-25.
3. Carbonell J, Cobo T, Balsa A, Descalzo MA, Carmona L. The incidence of rheumatoid arthritis in Spain: results from a nationwide primary care registry, Rheumatology, 2008, vol. 47(pg. 1088-92)
4. Symmons D, Turner G, Webb R, et al. . The prevalence of rheumatoid arthritis in the United Kingdom: new estimates for a new century, Rheumatology, 2002, vol. 41(pg. 793-800)
5. Plenge RM. Rheumatoid arthritis genetics: (2009). update, Curr Rheumatol Rep , 2009, vol. 11 (pg. 351-6)
6. Gonzalez A, Maradit KH, Crowson CS, et al. . The widening mortality gap between rheumatoid arthritis patients and the general population, Arthritis Rheum , 2007, vol. 56 (pg. 3583-7)
7. Robbinson JJ, Watson F,Phelan M, Bucknall RC, Edwards SW (1993). Activation of neutrophils by soluble and insoluble immunoglobulin aggregates from synovial fluid of patients with rheumatoid arthritis. Ann Rheum Dis 52:347-353
8. Black DR, Merry P, Unsworth J, Kidd BL, Outwait JM, Ballard R, Morris CJ, Gray L, Lunec J (1989) Hypoxic-reperfusion injury in the inflamed human joint. Lancet 1:289-293
9. Babior BM (2000) Phagocytes and oxidative stress. Am J Med 109:33-44
10. Gutteridge JMC, Stocks J (1989) Ceroluplasmin: physiological and pathological perspectives. Crit Rev Clin Lab Sci 14:257-329
11. Cimen MYB, Cimen OB, Kacmaz M, Oztruck HS, Yorgancioglu R, Durak I (2000) Oxidant/antioxidant status of the erythrocytes from patients with rheumatoid arthritis. Clin Rheumatoid 19:275-277
12. Gambhir JK, Lali P, Jain AK (1997) Correlation between blood antioxidant level and lipid peroxidation in rheumatoid arthritis. Clin Biochem 30:351-355
13. Kerimova AA, Atalay M, Yousifov EY, Kuprin SP, Kerimov TM (2000) Antioxidant enzymes; possible mechanism of gold compound treatment in rheumatoid arthritis. Pathophysiology 7:209-213
14. Lotz M (1999) The role of nitric oxide in articular cartilage damage. Rheum Dis Clin North Am 25, 269–82.
15. Tiku ML, Gupta S, Deshmukh DR (1999) Aggrecan degradation in chondrocytes is mediated by reactive oxygen species and protected by antioxidants. Free Radical Res
395–405
16. Fletcher DS, Widmer WR, Luell S, et al. (1998) Therapeutic administration of a selective inhibitor of nitric oxide synthase does not ameliorate the chronic inflammation and tissue damage associated with adjuvant-induced arthritis in rats. J Pharmacol Exp Ther 284, 714–21
17. Clancy RM, Amin AR, Abramson SB (1998). The role of nitric oxide in inflammation and immunity. Arthritis Rheum 41, 1141–51.
18. Moshage H, Kok B, Huizenga JR, Jansen PLM (1995) Nitrite and nitrate determinations in plasma: a critical evaluation. Clin Chem 41, 892–6
19. Rowley D, Gutteridge JM, Blake D, Farr M, Halliwell B (1984) Lipid peroxidation in rheumatoid arthritis: thiobarbituric acid-reactive material and catalytic iron salts in synovial fluid from rheumatoid patients. Clin Sci (Lin) 66, 691–5.
20. Taysi S, Polat F, Gul M, San RA, Bakan E (2002) Lipid peroxidation, some extracellular antioxidants, and antioxidant enzymes in serum of patients with rheumatoid arthritis. Rheumatol Int 21, 200–4.
21. Dai L, Lamb DJ, Leake DS, et al. (2000) Evidence for oxidized low density lipoprotein in synovial fluid from rheumatoid arthritis patients. Free Radic Res 32, 479–86.
22. Dalle-Donne I, Rossi R, Giustarini D, Milzani A, Colombo R (2003) Protein carbonyl groups as biomarkers of oxidative stress. Clin Chim Acta 329, 23–38.
23. Ian S, Young (2005) Oxidative stress and vascular disease: insights from isoprostane measurement. Clin Chem 51, 14–5
24. Tiku ML, Shah R, Allison GT (2000) Evidence linking chondrocyte lipid peroxidation to cartilage matrix protein degradation. Possible role in cartilage aging and the pathogenesis of osteoarthritis. J Biol Chem 275, 20069–76
25. Das UN (1990) Free radicals: biology and relevance to disease. JAPI 38, 495–8
26. Marlene, F. Lisa, B. Lyn, M. Damian, H. Ester, E. Peter, B. (2011). The epidemiology of rheumatic diseases in Asia. International journal of Rheumatic Diseases, 14, 113-121.
27. Nicole, M.W., Ellen, M.G. (2010).Bone remodeling in Rheumatic diseases: a question of Balance. Immunological Review, 233, 301-312.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Sehar Gulzar
Sr. Lecturer MLT, Fatima Memorial Hospital Institute of Allied Health Sciences, Lahore, Pakistan.
Abubakar Imran
Vice Principal, PKLI, Institute of Nursing & Allied Health Sciences Lahore, Pakistan.
Tauseef Sharif
Medical Laboratory Technologist, Department of Pathology & Laboratory Medicine, Ministry of National Guard Health Affair, Riyadh, Saudi Arabia.
Zoha Sohail
PhD Scholar / Sr. Lecturer Nutrition, Fatima Memorial Hospital Institute of Allied Health Sciences, Lahore, Pakistan.
Rimsha Badar
Lecturer MIT, Fatima Memorial Hospital Institute of Allied Health Sciences, Lahore, Pakistan.
Aamna Tanveer Khan
Quality Executive, Institute of Quality and Technology Management, University of the Punjab, Pakistan.
Sidra Inam
Lecturer MIT, Fatima Memorial Hospital Institute of Allied Health Sciences, Lahore, Pakistan.
Atif Munir
Lecturer MLT, Fatima Memorial Hospital Institute of Allied Health Sciences, Lahore, Pakistan.