title: Antioxidant status in rheumatoid arthritis and role of antioxidant therapy.
abstract: BACKGROUND
  Oxygen free radicals have been implicated as mediators of tissue damage in patients of rheumatoid arthritis (RA). This study was designed to elucidate plasma oxidant/antioxidant status in rheumatoid arthritis, with the aim of evaluating the importance of antioxidant therapy in the management of this disease.
  
  
  METHODS
  The study included 40 patients of rheumatoid arthritis who were randomly divided into two subgroups of 20 each. One group received conventional treatment for 12 weeks and in the other group conventional treatment was supplemented with antioxidants for the same duration. Twenty age- and sex-matched normal individuals constituted the control group. Blood samples of controls and patients were collected at the time of presentation and analyzed for total thiols, glutathione, vitamin C and malondialdehyde (MDA-marker of oxidative stress). The investigations were repeated in the patients after 12 weeks.
  
  
  RESULTS
  The blood concentrations of total thiols, glutathione and vitamin C were found to be significantly lower in rheumatoid arthritis patients as compared to healthy controls, while the concentrations of MDA were much higher. There was a statistically significant increase in the posttreatment concentrations of these antioxidants, along with a decrease in the concentrations of MDA.
  
  
  CONCLUSIONS
  The antioxidant defense system is compromised in rheumatoid arthritis patients. There is a shift in the oxidant/antioxidant balance in favor of lipid peroxidation, which could lead to the tissue damage observed in the disease. The results suggest the necessity for therapeutic co-administration of antioxidants along with conventional drugs to such patients. However, due to the limited number of cases included in this study, more studies may be required to substantiate the results and arrive at a definite conclusion, in terms of safety and efficacy of adding on antioxidant therapy for the treatment of RA.
authors.affiliation: Department of Biochemistry, GMCH, H No. 2506-A, Sector 47-C, Chandigarh 160047, India. jasbinderkaur@yahoo.co.in
authors.forename: Shivani
authors.initials: S
authors.lastname: Jaswal
authors.forename: Harish Chander
authors.initials: HC
authors.lastname: Mehta
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Sood
authors.forename: Jasbinder
authors.initials: J
authors.lastname: Kaur
mesh_terms: D000975:Antioxidants / Q000378:metabolism* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D001205:Ascorbic Acid / Q000097:blood; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D013438:Sulfhydryl Compounds / Q000097:blood
chemical_list: D000975:Antioxidants; D013438:Sulfhydryl Compounds; D008315:Malondialdehyde; D005978:Glutathione; D001205:Ascorbic Acid