Determination of dynamic thiol / disulfide relation in rheumatoid artritis patients

Aim: Overproduction of free radicals or insuffiency of antioxidant defence mechanisms causes disturbance in the pro-anti oxidant balance. Oxidative stres is a biochemical condition that is toxic effect of high levels of reactive oxygen species (ROS) at cells. Thiols are a class of organic compounds that contain a functional sulfhydryl group. Dynamic thiol disulphide homeostasis status has critical roles in antioxidant protection, detoxification, signal transduction, apoptosis, regulation of enzymatic activity and transcription factors and cellular signalling mechanisms. There is growing body of evidence demonstrating that an abnormal thiol disulphide homeostasis state is involved in the pathogenesis of a variety of diseases, including diabetes, cardiovascular disease, cancer, rheumatoid arthritis, chronic kidney disease, Alzheimer's disease, multiple sclerosis and chronic liver disorder. In this study, dynamic thiol / disulfide balance evaluation was planned in the group representing the rheumatoid arthritis population. Material and method: 100 patients with rheumatoid arthritis and 100 healthy subjects were enrolled in the study between December 1, 2014 and December 31, 2015, at the Ankara EAH Rheumatology Clinic. The study is a prospective, case-control study. 100 volunteer RA patients and 100 age and sex-matched control subjects were included in the study. Patients with a disease that may affect the thiol pool due to hypoalbuminemia such as chronic renal failure, nephrotic syndrome, malnutrition and chronic liver disease have not been studied. Patients taken in the study group: Healthy individuals aged 18-65 years who did not have systemic chronic disease that could affect thiol and disulfide levels were selected for the control group. (WBC), hemoglobin, platelet (Plt), glucose, urea, creatinine, aspartate amino transferase (AST), alanine amino transferase (ALT) in the blood taken at the time of admission, , Albumin, protein, blood sedimentation rate, CRP, total cholesterol, LDL cholesterol, HDL cholesterol values, also das28 score for the patient group, alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), sodium , RF and anti-CCP values were measured. Biochemistry, hemogram, thiol and disulfide levels were obtained in the patient and control group after 8 hours of fasting. Thiol-disulfide measurements were made on the day of first RA diagnosis in the patient group. Yıldırım Beyazıt University Ankara Atatürk EAH Ethics Committee approved for the study. All parameters were studied at Ankara Atatürk EAH, Clinical Biochemistry and Hormone Laboratory Blood thiol disulfide parameters were studied in a Roche Hitachi Cobas c501 automatic analyzer at the Ankara Atatürk EAH Biochemistry Laboratory with the automatic measurement method newly developed by Erel & Neselioglu, after centrifugation of thalon thiol and disulfide samples at 3600 rpm for 10 minutes in biochemistry laboratory. Demographic characteristics, test results and thiol parameters (native thiol [-SH], total thiol [-SH+-S-S-], disülfide [-S-S-], and calculated as a percentage disülfide/native thiol [-S-S-/-SH], disülfide/total thiol [-S-S-/-SH+-S-S-], native thiol/total thiol [-SH/-SH+-S-S-] were compared between the study and control groups. Results: Patients who were involved into this study consisted of 86% female and 14% male. The average of their ages varied between 46,3 and 12,03 and the average value of the sedimentation is seen 26.92±16.41. The average CRP value was 9.13±9.9. In our patients with Rheumatoid arthritis , 59% anti-CCP+ and 47% RF+ were seen. After the comparison made between tiyol/disülfid levels of the patients with Anti-CCP+ and Anti-CCP-, no noteworthy discrepancy was detected. The same thing can be said for the results of the comparison made between thiol/disülfide levels of the patients with RT(+) and RF(-). Das28 level of the patients with Rheumatoid arthritis was classified. In 14% of these patients, das28 was less than 2.6; in 19% of them, das28 was between 2.6 and 3.2; in 53% of them das28 was between 3.2-5.1, and in 14% of them, das28 was more than 5.1. The comparisons were made between Romatoid Artrit patients' das28 illness activities and the values of their thiol/disülfide. No noteworthy discrepancy was detected between four groups. Thiol/disülfide levels of the patients with Rheumatoid arthritis and health control group were compared. There was no difference detected between the groups as far as gender and age are concerned. However, there was a noteworthy difference detected between thiol/disülfide values in favor of patient group Conclusion: In literature, the development of thiols, some diseases and their effects on prognosis are under investigation. Our study was the first study to examine the relationship between rheumatoid arthritis and thiol compounds according to the method of Erel and Neşelioğlu. As a result, it was determined that the thiol disulfide level increased and the oxidative stress level increased in patients with rheumatoid arthritis Key Words: Thiol, disulfide, oxidative stress, free oxygen radicals, Rheumatoid arthritis