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0007 -4888/09/14830497 © 2009 Springer Science+Business Media, Inc.
Effect of Artrofoon and SCENAR Therapy on Parameters
of LPO and Antioxidant System of the Blood in Patients
with Peritonitis in Postoperative Period
A. V. Tarakanov, S. Kh. Luspikayan,
N. P. Milyutina, and A. V. Rozhkov
Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 148, Suppl. 1, pp. 136-139, September, 2009
Original article submitted August 1, 2008
Administration of artrofoon in combination with SCENAR therapy to patients with localized sup-
purative peritonitis in the postoperative period considerably reduced plasma MDA level, stabilized
ceruloplasmin activity, and increased catalase activity in erythrocytes compared to the correspond-
ing parameters in patients receiving standard treatment in combination with SCENAR therapy.
Key Words: suppurative appendicular peritonitis; artrofoon; self-controllable energoneu-
roadaptive regulator (SCENAR); lipid peroxidation; antioxidant enzymes
Department of Urgent Medicine, Rostov State Medical University,
Rostov-on-Don
Pronounced endogenous intoxication accompanying
suppurative peritonitis (SP), mixed-type hypoxia, and
hypovolemia lead to signifi cant activation of free-ra-
dical LPO processes, which becomes a leading com-
ponent in the pathogenesis of cell alteration [6,7]. The
course of the infl ammatory process is interrelated with
the state of plasma membranes, which undergo destruc-
tive changes [8,12]. Destruction of membranes under
the effect of endogenous and exogenous factors trig-
gers pathochemical processes affecting the functions
of various systems and the whole organism [3]. LPO
processes play a role of a molecular trigger mecha-
nism during the formation of adaptation mechanisms;
activation of these processes is a universal response
of the organism to extreme exposures. Antioxidant
system regulates the intensity of LPO processes in the
blood and cells and the concentration of endogenous
lipoperoxides [1,18].
Correction of LPO is an essential, but little stu-
died method of SP treatment. Apart from drug therapy,
other methods of LPO correction are known. For in-
stance, information infl uence by means of bioregulated
low-frequency pulse electrotherapy, in particular, with
self-controllable energoneuroadaptive regulator SCE-
NAR [11] is a promising method [11].
Acute suppurative infection is accompanied by
enhanced production of cytokines and LPO activa-
tion. TNF-α, one of the most active mediators, triggers
a cascade of proinfl ammatory cytokines. It activates
macrophages and interferes the process of respiratory
burst in phagocytes. Addition of artrofoon, a prepara-
tion containing antibodies to TNF-α in ultralow doses,
to complex therapy of patients with SP is advisable
against the background of excessive inflammatory
process. We found no published data on the use of
artrofoon in SP, administration of this preparation in
short courses, and its effect on the parameters of LPO
and antioxidant system.
Here we studied the effect of artrofoon as a com-
ponent of complex therapy with the use of SCENAR
on parameters of LPO in the blood and erythrocytes
and activity of the main antioxidant enzymes in pa-
tients with suppurative appendicular peritonitis in the
postoperative period.
MATERIALS AND METHODS
We examined 99 patients (76 men and 23 women,
age 17-74 years) operated for acute appendicitis com-
Bulletin of Experimental Biology and Medicine, Vol. 148, Suppl. 1, 2009 ULTRALOW DOSES
498
plicated by localized SP. The diagnosis was made
on the basis of clinical examination and biochemical
blood tests. The patients were randomly divided into
3 groups. During the postoperative period, group 1
patients (n=42) received standard therapy; in group
2 patients (n=38) this standard treatment was sup-
plemented with SCENAR-therapy. Group 3 patients
(n=19) received artrofoon (1 sublingual tablet 4 times
a day, every 6 h) in addition to complex therapy pre-
scribed to group 2 patients. Artrofoon treatment was
performed until elimination of fever (5 days on aver-
age) and attaining clinical improvement. SCENAR
procedure consisted in stimulation of the skin on palms
(thenar and hypo thenar) and feet (zone under fi ngers
regio plantaris pedis) with remote electrodes (12 cm2)
in the F-Sw mode (10 min for each zone) followed by
treatment of the skin projection of the liver (including
F
13 и F14 points of the liver meridian). The strength of
stimulation was chosen individually [11].
The control group comprised 38 age-matched heal-
thy individuals.
Blood plasma, 1% hemolysate, and erythrocyte
suspension were analyzed. Chemiluminescent (CL)
analysis in the H
2O2–luminol system [13] was used;
the intensity of LPO was evaluated by accumulation
of molecular products in chloroform extract of lipids
[16]; the content of diene conjugates (DC) [9], MDA
[10], and Schiff bases [15] and activity of SOD [17],
catalase [5], and ceruloplasmin by the method of Re-
vin with modifi cations [4] were measured. The studies
were carried out in biochemical laboratory of Research
Institute of Biology, South Federal University, on days
3-5 after surgery (initial data) and on day 5 after the
start of complex treatment.
The data were processed statistically using Stu-
dent t test.
RESULTS
The initial biochemical parameters in 3 groups re-
fl ected enhanced generation of reactive oxygen spe-
cies, potent LPO inductors (Table 1). In all groups,
the amplitude of fast fl ash, parameter of induced CL,
surpassed the normal value by 29.9-42.6%. The total
CL yield refl ecting the rate of utilization of lipid radi-
cals due to their interaction with other lipid radicals
or endogenous antioxidants was signifi cantly elevated
only in groups 1 and 2.
The plasma level of DC in all groups before the
start of treatment was signifi cantly elevated by 43.4-
55.1%. In groups 1-3, the content of MDA was sig-
nifi cantly increased by 60.8, 82.8, and 55.1%, respec-
tively, and the content of Schiff bases was increased
by 51.5, 61.6, 24.2%, respectively.
MDA-type LPO products are bifunctional cross-
linking agents inducing the formation of high-molec-
ular weight end-products, Schiff bases. This leads to
considerable and sometimes irreversible changes in the
structure and function of membranes.
More pronounced changes in LPO intensity were
observed in erythrocytes (Table 2). In contrast to blood
plasma, where the initial scatter of data was observed,
TABLE 1. Intensity of H
2O2-Luminol-Induced CL, LPO, and Activity of Antioxidant Enzymes in Blood Plasma in the Studied
Groups (M±m)
Parameter Control
Group 1 Group 2 Group 3
initial
value after
5 days initial
value after
5 days initial
value after
5 days
Fast CL flash
amplitude, mm 43.8±4.1 62.5±11.0 71.9±7.5* 60.9±7.5* 53.5±4.2 56.9±4.1* 47.4±8.3
CL yield, ×104,
rel. units 84.1±2.1 120.0±30.6 164.5±21.3* 136.1±13.3* 153.3±33.7* 93.7±11.9 83.7±9.9
DC, nmol/ml 14.5±1.8 20.8±1.0* 20.3±1.6* 21.1±1.4* 18.2±0.5*+ 22.5±1.1* 19.2±2.6
MDA, nmol/ml 25.0±1.8 40.2±2.9* 47.2±2.9* 45.7±2.2* 39.6±2.0*+ 36.8±2.8* 29.7±2.2+o
Schiff bases,
rel. units/ml 0.99±0.05 1.5±0.1* 1.30±0.07* 1.6±0.2* 1.3±0.1* 1.23±0.09* 1.34±0.08*
Ceruloplasmin,
μmol/liter 1.2±0.1 1.4±0.1* 0.90±0.08*+ 1.1±0.1 1.0±0.1 1.6±0.1* 1.5±0.1*o
Catalase,
nmol H
2O2/ml 14.9±0.9 11.8±1.1* 14.5±2.0 12.4±1.7 17.2±3.2 10.90±1.81* 15.4±0.40
+
Note. Here and in Table 2: p<0.05 compared to:*control, +initial value, ogroup 2.
Bulletin of Experimental Biology and Medicine, Vol. 148, Suppl. 1, 2009 ULTRALOW DOSES
499
parameters of erythrocytic LPO in all groups underwent
pa rallel changes. The plasma level of DC in all groups
before the start of treatment was signifi cantly elevated
by 123.6, 112.8, and 133.2%. MDA content surpassed
the control by 53.1, 48.2, and 53.1%, respecti vely,
and the content of Schiff bases was increased by 26.3,
22.8, 28%, respectively. Excessive peroxidation con-
siderably modulated cell functions [2].
In patients with SP transferred from intensive care
unit to surgical ward, the generation of reactive oxy-
gen forms possessing a wide range of cytotoxic effects
remained elevated, the intensity of LPO considerably
increased. LPO induced a vicious circle of disturbanc-
es in cell bioenergetics and homeostasis, which, if not
broken, leads to cell disintegration.
The intensity of free-radical oxidation reactions
depends on the state of the antioxidant system in tis-
sues and biological fl uids, e.g. blood plasma. In our
study, components modulating the mechanisms of
sanogenesis were added to the complex treatment of
patients of groups 2 and 3.
Standard therapy (group 1) did not eliminate oxi-
dative stress in blood plasma on day 5. CK further
increased to 64.1% compared to the normal and to
15% compared to initial value. In groups 2 and 3,
this parameter tended to decrease by 12.1 and 16.6%,
respectively. The concentrations of DC and MDA also
decreased in groups 2 and 3 (in group 1 these parame-
ters did not decrease). Signifi cant contribution to these
changes was made by artrofoon: on day 5, the content
of MDA in group 3 only insignifi cantly surpassed the
control level (by 18.8%)
This decrease was accompanied by signifi cant chan-
ges in activity of antioxidant enzymes. In group 1, initial
ceruloplasmin activity was increased by 16.6%, but af-
ter 5 days this parameter signifi cantly decreased (-25%).
In group 3, this activity was initially high (+33.3%)
and remained elevated at later terms (+25%). Increased
activity of ceruloplasmin is a defense and compensatory
reaction, because it regulates LPO intensity by entrap-
ping both superoxide anion radical and hypochlorite;
moreover, ceruloplasmin ex hibits ferroxidase activity
and reduces the level of Fe2+. Catalase activity in groups
2 and 3 returned to normal and surpassed it, which was
not observed in group 1.
Acute process during the development of localized
ap pendicular SP against the background of satisfactory
general health status determines more rapid recovery
of the status of LPO and antioxidant system. In all
groups, the content of MDA and Schiff bases signifi -
cantly decreased (Table 2). DC production remained
high in group 1 and decreased by 32.9 and 38.3% in
groups 2 and 3, respectively.
SOD activity increased in all groups. In group 3,
the pronounced increase in catalase activity made a
great contribution into the effect of treatment. In groups
1 and 2, catalase activity decreased by day 5, while in
group 3 it signifi cantly increased by 7.7% compared to
baseline and 22.1% compared to group 2 (р<0.05).
Thus, postoperation period of localized appendicular
SP was characterized by enhanced generation of reac-
tive oxygen species, which was seen from consider ably
increased parameters of induced CL and eleva ted content
of molecular LPO products in the plasma and erythro-
cytes; catalase activity in the plasma and SOD activity
in erythrocytes decreased under these conditions.
Standard therapy did not eliminate the symptoms
of oxidative stress, which was confi rmed by high CL
parameters and increased MDA content in the plasma.
SCENAR therapy decreased oxidative stress by day
5 and decreased the content of DC and MDA in the
plasma and erythrocytes.
The use of SCENAR therapy and artrofoon in
the complex treatment reduced oxidative stress in the
blood, signifi cantly decreased plasma MDA, content,
and increased plasma catalase activity. The contribu-
TABLE 2. LPO Intensity and Activity of Antioxidant Enzymes in Erythrocytes in the Studied Groups (M±m)
Parameter Control
Group 1 Group 2 Group 3
initial
value after
5 days initial
value after
5 days initial
value after
5 days
DC, nmol/mg Hb 7.16±0.72 16.01±0.49* 14.43±0.48*+ 15.24±0.72* 10.22±0.81*+ 16.7±1.1* 10.30±1.52+
MDA, nmol/mg Hb 3.46±0.36 5.32±0.31* 4.53±0.24+ 5.13±0.31* 4.21±0.19+ 5.30±0.31* 3.90±0.20+
Schiff bases,
rel. units/mg Hb 0.57±0.05 0.72±0.04* 0.60±0.06 0.7±0.1 0.59±0.04 0.73±0.06* 0.60±0.03+
SOD, U/mg Hb 3.35±0.11 3.10±0.23 3.41±0.15 2.80±0.21* 3.24±0.21 3.22±0.20 3.54±0.12
Catalase,
nmol H
2O2/mg Hb 26.40±1.07 31.60±3.28 31.10±1.34* 34.5±3.9* 30.80±1.82* 34.90±4.30 37.60±3.90*
o
A. V. Tarakanov, S. Kh. Luspikayan, et al.
500
tion of artrofoon consisted in a signifi cant decrease in
MDA content in the plasma, maintenance of cerulo-
plasmin activity, and elevation of catalase activity in
erythrocytes.
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Bulletin of Experimental Biology and Medicine, Vol. 148, Suppl. 1, 2009 ULTRALOW DOSES
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