Evaluation of oxidant stress in Wilson's disease and non-Wilsonian chronic liver disease in childhood.
OBJECTIVE
Oxygen free radicals have an important role in the pathogenesis of acute and chronic liver disease. Free radical formation and oxidative damage, probably mediated with copper accumulation, are important in Wilson's disease pathogenesis. This study was performed to determine if accumulating copper in Wilson's disease is a cause of further oxidant stress compared to non-Wilsonian liver disease.


METHODS
In this study, we investigated plasma malondialdehyde and nitric oxide levels to estimate the oxidant stress and total antioxidant capacity and vitamin E/cholesterol, vitamin C and beta-carotene levels to estimate the antioxidant status of patients. The groups investigated included 24 patients with Wilson's disease (group I), 25 patients with non-Wilsonian chronic liver disease (group II) and 23 healthy controls (group III). Wilson's disease and non-Wilson's disease patients were divided into subgroups according to disease stage (i.e. chronic hepatitis and cirrhosis) and all parameters were compared between subgroups and controls.


RESULTS
Malondialdehyde and nitric oxide levels were higher than controls in groups I and II (p=0.013, p=0.01), but these levels did not differ between the Wilson's disease and non-Wilson's disease groups. The parameters were also evaluated with respect to the disease stage (i.e. chronic hepatitis and cirrhosis), and there was no difference between groups I and II. Although malondialdehyde and nitric oxide levels were significantly different between both disease stage groups and the controls, we observed decreased vitamin C and beta-carotene levels only in cirrhosis stage (p=0.01, p=0.01).


CONCLUSIONS
We observed the presence of oxidant stress unrelated to the etiology of the liver disorder in our study. Deficiency of the major antioxidants, vitamin C and beta-carotene, develops as the disease stage advances from chronic hepatitis to cirrhosis.
Dalgiç
Buket
B
Department of Pediatric Gastroenterology, Gazi University Faculty of Medicine, Cayyolu, Ankara, Turkey. buketdalgic@yahoo.com
Sönmez
Nesrin
N
Biberoğlu
Gürsel
G
Hasanoğlu
Alev
A
Erbaş
Deniz
D
D000975:Antioxidants / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D002648:Child; D005260:Female; D006521:Hepatitis, Chronic / Q000097:blood*; D006527:Hepatolenticular Degeneration / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D009569:Nitric Oxide / Q000097:blood*; D018384:Oxidative Stress / Q000502:physiology*; D012720:Severity of Illness Index; D013050:Spectrometry, Fluorescence
D000975:Antioxidants; D015415:Biomarkers; D009569:Nitric Oxide; D008315:Malondialdehyde