Evaluation of oxidative stress in the thrombolysis of pulmonary embolism.
BACKGROUND
To analyse leukocyte function parameters and oxidative stress (OS) in patients with acute pulmonary embolism (PE) treated with thrombolytics.


METHODS
Fifteen patients undergoing thrombolysis (TL) with ultra-high dose streptokinase (n = 8), or alteplase (tPA) (n = 7) treatment were studied. Blood samples were collected prior to TL, and then 8 h, 1, 3, 5 and 30 days after treatment. Malondialdehyde (MDA), reduced glutathione (GSH), plasma protein sulfhydryl groups (PSH) levels, superoxide dismutase (SOD) and myeloperoxidase enzyme (MPO) activities were measured in plasma or whole blood for monitoring of the OS markers. Production of reactive oxygen species (ROS) in whole blood was measured by luminol dependent chemiluminescence. Flow cytometry was used to determine CD11a, CD18, and CD97 surface antigen expression on leukocytes.


RESULTS
The elevated MDA, ROS and MPO, decreased GSH and PSH levels indicated the presence of OS in patients with PE. MDA significantly (P < 0.05) increased, GSH significantly (P < 0.05) decreased following thrombolysis. ROS production peaked on the 3rd and 5th days. TL was accompanied by significant decrease in granulocyte and monocyte CD11a and CD18 as well as in granulocyte CD97 expression (P < 0.05).


CONCLUSIONS
PE led to OS that was augmented following TL. Decreased adhesion molecule expression of circulating leukocytes in the early phase of TL reflects the pathological leukocyte endothelial cell interactions.
Mühl
Diana
D
Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, University of Pécs, Ifjúság u. 13, H-7624, Pécs, Hungary. Diana.Muhl@aok.pte.hu
Füredi
Réka
R
Cristofari
Julia
J
Ghosh
Subhamay
S
Bogár
Lajos
L
Borsiczki
Balázs
B
Gasz
Balázs
B
Roth
Elizabeth
E
Lantos
János
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042783:Endothelial Cells / Q000502:physiology; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D005978:Glutathione / Q000097:blood; D006801:Humans; D007962:Leukocytes / Q000378:metabolism; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D009195:Peroxidase / Q000097:blood; D011655:Pulmonary Embolism / Q000097:blood / Q000188:drug therapy*; D013300:Streptokinase / Q000494:pharmacology*; D013482:Superoxide Dismutase / Q000097:blood; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000494:pharmacology*
D005343:Fibrinolytic Agents; D008315:Malondialdehyde; D009195:Peroxidase; D013482:Superoxide Dismutase; D013300:Streptokinase; D010959:Tissue Plasminogen Activator; D005978:Glutathione