Serum Nitric Oxide and Malon Dialdehyde as Markers for Oxidative Stress in Juvenile Idiopathic Arthritis and its Relation to Disease Activity

Abstract

SUMMARY AND CONCLUSION I n this study, we were concerned to assess serum NO and MDA among a group of Egyptian children with pediatric JIA as markers for oxidative stress and its relation to disease status and different therapeutic modalities. We conducted this study on 20 children with pediatric JIA attending the pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University. They were compared with 20 age-matched healthy control cases. Clinical evaluation of JIA patients with assessment of the disease activity using ACR recommendations was done. Routine laboratory investigations including CBC, ESR, CRP, RF, ANA and lipid profile (S.chol, TG, HDL, and LDL) for all patients. Serum NO and MDA was measured for the studied patients and age-matched healthy control group. the studied patients had significantly higher levels of serum NO and MDA as compared to healthy controls, with cases showing higher mean NO (260.2 Vs 104.4) and higher mean MDA (14.2 Vs 2.3). The current study showed no significant relation between personal and medical data (age, sex, Consanguinity and associated co-morbidity) and serum NO level.

There was no significant relation between personal and medical data (age, sex, Consanguinity and associated co-morbidity) and serum MDA level among cases except disease activity, more disease activity associated with higher serum MDA level. No significant relation was observed between the type of JIA and serum NO level. But there were high significant relation between presence of arthralgia, arthritis and morning stiffness and high serum NO level. No significant relation was observed between the type of JIA and serum MDA level, but there were high significant relation between presence of arthralgia, arthritis and morning stiffness and high MDA serum level. There was no significant relation between lab. Characteristics (CBC, RF, ANA and dyslipidemia) and serum NO level among cases except for CRP and ESR there was a significant positive relation between CRP and ESR and serum NO level. There was no significant relation between lab. Characteristic (CBC, RF and ANA ) and serum MDA level among cases except for CRP, ESR and dyslipidemia there was a significant positive relation founded between (CRP, ESR and dyslipidemia) and serum MDA level. Serum NO had no significant relation to TTT received (Steroid, Methotrexate and Biological drugs). Serum MDA had no significant relation to TTT received (Steroid and Biological drugs) except for methotrexate, there was a significant positive relation between serum MDA and methotrexate administration. A significant positive correlation was founded between serum NO and MDA concentrations and JIA activity. There was a significant positive correlation between methotrexate dose and serum NO but no significant correlation with other drug doses; however no significant correlation was found between all drug doses and serum MDA. In conclusion, serum NO and MDA levels were significantly higher among patients with JIA than the healthy controls with highest levels in those with active disease. This supports the validity of serum NO and MDA levels in JIA patients as markers for oxidative stress and its significant relation to disease activity. Further studies on a wider scale are needed to strengthen the finding of this study, to validate the usefulness of these biomarkers and for better understanding of its role as predictor of outcome of JIA patients.