Investigation of oxidative and nitrosative stress in crohn patients

Crohn's Disease is an inflammatory bowel disease that can affect the entire gastrointestinal tract from the mouth to the anus, characterized by skipped involvement and progressing with relapses and remissions. in the development of Crohn's disease; Changes in the intestinal microbiome, deterioration in the intestinal mucosa and genetic factors are held responsible. In addition, oxidative stress is thought to make an important contribution to the tissue damage and fibrosis that characterizes the disease. An imbalance between increased reactive oxygen species levels and decreased antioxidant defense occurs in patients with Crohn's. The aim of this study; To identify and evaluate the possible contributions of dynamic thiol/disulfide homeostasis, glutathione, glutathione peroxidase, myeloperoxidase, 3-nitrotyrosine, and nitric oxide to the pathophysiology of Crohn's disease. Between 01.06.2021 and 30.10.2022, a total of 76 patients, 38 of whom were diagnosed with Crohn's disease andaccepted as active patients, 38 of whom were in remission, were prospectively evaluated in Gaziantep University, Department of Internal Medicine, Gastroenterology Department.Age, gender, smoking history, disease age, smoking status, routine complete blood count and biochemical parameters and oxidative stress and nitrosative stress markers were recorded in all patients included in the study. NO, MPO, 3-NT, natural thiol, total thiol, natural/total thiol, disulfide/natural thiol, disulfide/total thiol markers were compared between active disease, remission group and control group. Glutathione and glutathione peroxidase enzyme activity levels were found to be significantly lower in both the active disease group and the remission group compared to the control group (p<0.001). Nitric oxide level, one of the nitrosative stress markers, was found to be significantly higher in the active disease and remission groups (p<0.001). Myeloperoxidase enzyme and 3-nitrotyrosine levels were found to be significantly lower in both groups (p<0.001). Natural thiol, total thiol level and natural/total thiol ratio, which are indicators of thiol/disulfide homeostasis, were found to be significantly lower in only two active disease groups compared to the control group (p<0.001, p<0.01 and p<0.001, respectively). Disulfide levels, disulfide/natural thiol and disulfide/total thiol ratios were found to be significantly higher in the active disease group than in the control group (p<0.01, p<0.001 and p<0.001, respectively). In our study, oxidative stress in Crohn's Disease increased especially during active disease and the thiol/disulfide mechanism was impaired in favor of oxidation. In the active disease group; decrease in antioxidant levels and increase in oxidative stress markers showed us that these results may be due to high level inflammation in patients. In addition, the emergence of different results in each of the nitrosative stress markers suggested that more comprehensive randomized controlled studies should be conducted on this subject.