Indices of peroxidation of proteins, lipids and antioxidant system as the markers of endogenous intoxication in patients with syndrome of obstructive sleep apnea

The syndrome of obstructive sleep apnea (OSAS) is accompanied by episodes of hypoxia and reoxygenation, which causes an increase in the level of active forms of free radicals that lead to the development of the oxidative stress. The aim of this work was to investigate the intensity of peroxidation of proteins and lipids, the components of the antioxidant system and the biochemical parameters endogenous intoxication in patients with OSAS. Materials and methods: Twenty patients with OSAS were examined at the SI "Prof. O.S. Kolomyychenko Institute of Otolaryngology NAMS of Ukraine" (Kiev). They were divided into two groups: 10 of them were with apnea sleep index less than 30 episodes of respiratory arrest per hour (IA<30), another 10 ones – with more than 30 episodes (IA>30). The control group was consisted of 10 healthy persons. The object of biochemical studies was blood serum. The intensity of the oxidative modification of blood serum proteins was estimated by 2,4-dinitrophenyl hydrazine reaction by Levin in modification of Reznick. The evaluation of the intensity of peroxide processes was determined by interaction with 2-thiobarbiturac acid (TBA) by the method of Goncharenko. The activity of catalase was determined by the method of Korolyuk et al. The content of free thiol groups (SH-) was determined by interaction with 5,5'-dithio-bis-(2-nitrobenzoic acid) by the method of Sokolovsky et al. The contents of medium weight molecules and tyrosine-containing peptides (TCP) were determined spectrophotometrically at 254 and 280 nm, respectively. Statistical processing of results was carried out using a program package of biometric data WinPEPI. Results: In patients with OSAS whose IA<30, an increase of the level of TCP, oxidative modification of proteins, the content of TBA-positive products and a decrease in the level of SH-groups. In patients with IA>30, increased levels of medium weight molecules, TСP, oxidative modification of proteins, the content of TBA-positive products and the activity of catalase. A significant difference was observed in patients with syndrome of obstructive sleep apnea of varying degrees of severity of the content of aldehyde and ketone derivatives of neutral proteins; aldehyde derivatives of the main nature, the content of TBA-positive products and the activity of catalase. Conclusions: The results of the conducted studies indicate an increase in the intensity of the processes of peroxidation of proteins and lipids, the change in the components of the antioxidant system and the development of endogenous intoxication in patients with OSAS.

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Prooxidant and antioxidant systems’ indices as the markers of endogenous intoxication in ronchopathy and syndrome of obstructive sleep apnea in the dynamics of treatment

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2021-3-32 ◽

2021 ◽

pp. 32-44

Author(s):

Yuriy V. Minin ◽

Natalya M. Voroshilova ◽

Julia B. Burlaka ◽

Julia G. Klys ◽

Tetiana I. Kucherenko ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Free Radicals ◽

Sleep Apnea ◽

Catalase Activity ◽

Sleep Apnea Syndrome ◽

The State ◽

Antioxidant Systems ◽

Control Group ◽

Endogenous Intoxication ◽

Obstructive Sleep

Introduction: Ronchopathy is a chronic progressive disease manifested by upper airway obstruction and chronic respiratory failure. The key process of pathological snoring is the obstructive breathing disorders. The obstructive sleep apnea syndrome (OSAS) develops on the basis of snoring. OSAS is accompanied by episodes of hypoxia and reoxygenation, which cause an increase of the level of reactive free radicals whith following development of the oxidative stress. The activation of peroxidative processes of proteins (POP) and lipids (POL) are initiated by free radicals which are noticeable components of endogenous intoxication (EI). The aim of the study was to investigate the intensity of POP and POL processes, the levels of OSAS components, and the indices EI in patients with ronchopathy and OSAS of varying severity in the dynamics of treatment. Materials and methods: 40 patients with ronchopathy and OSAS were examined at the State Institution “Institute of otolaryngology named after prof. O.S. Kolomiychenko of the National Academy of Medical Sciences of Ukraine”. All patients were divided according to the degree of snoring and hypoxia index (HI) into 4 groups of 10 persons each. Control group was formed by 10 healthy donors. The object of biochemical studies was blood serum. The intensity of POP was assessed by reaction with 2,4-dinitrophenyl-hydrazine by the Levin’s method in Reznick’s modification. POL intensity was determined by the interaction with 2-thiobarbituric acid (TBA) by Goncharenko. Catalase activity was determined by the method of Korolyuk and co-authors. The content of free thiol groups was determined by interaction with 5,5'-dithio-bis(2-nitrobenzoic acid). The content of medium weight molecules (MWM) and tyrosine-containing peptides (TCPs) were determined by spectroscopy at 254 and 280 nm, respectively. Statistical processing of the results was performed using the software package for biometric data WinPEPI. Results: Prior to the treatment in patients with ronchopathy and OSAS of varying severity, an increase in the content of MWM and TCPs were noted, that indicates the development of endogenous intoxication. In patients of all groups there was an intensification of POP, which was manifested by a significant increase of aDNFGn, aDNFGo, and kDNFGn levels. The content of TBA-positive products in patients with ronchopathy of both groups was at the level of control and increased significantly at progression of pathological process. In addition, in all groups of patients an increase of catalase activity was detected on the background of TCPs level decrease. It was found the efficacy of the offered treatment of patients with ronchopathy and OSAS of varying severity. The indices of EI, POP, POL, and antioxidant system’s were directed to improvement in contrast to the state before treatment, and some of them were improved almost to the level of control. Conclusions: It is established that the progression of hypoxia is accompanied by autointoxication, which is manifested by an increase in the content of MWM, as well as prove for the activation of catabolic reactions and excessive formation of cells’ breakdown products. It was also revealed by the intensification of POP and POL processes, the activation of which are associated with the development of insufficiency of enzymatic and nonenzymatic components of antioxidant system. The performed treatment can be considered as the effective one since on its completion all the studied indices were restored almost to the level of control.

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Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig5-2019-0005 ◽

2019 ◽

Vol 4 (5) ◽

pp. 878-892

Author(s):

Joseph A. Napoli ◽

Linda D. Vallino

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

A Priori ◽

Sufficient Evidence ◽

Obstructive Sleep ◽

Before And After ◽

Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

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