title: Determination of potential role of antioxidative status and circulating biochemical markers in the pathogenesis of ethambutol induced toxic optic neuropathy among diabetic and non-diabetic patients.
abstract: The present study was designed to explore the antioxidative status and circulating biochemical markers having a potential role in the pathogenesis of ethambutol (EMB) induced toxic optic neuropathy (TON) among diabetic and non-diabetic patients. Fifty patients under complete therapy of EMB for tuberculosis were included in the present study. Inclusion criteria for patients were to receive EMB everyday during treatment, a dose of 25 mg/kg for initial 2 months and 15 mg/kg during the rest of therapy period. We conducted color vision and visual acuity test for all patients. Fifteen out of fifty EMB induced TON patients, were found to be diabetic. Color vision and visual acuity test results were evaluated for diabetic and non-diabetic as well as twenty age matched controls. The results demonstrated a significant pattern of circulating biochemical markers between the studied groups. Data regarding hematological (RBC, p value = 0.02; Hemoglobin, p value = 0.02), hepatic (total bilirubin, p value = 0.01), renal (urea, p value = 0.03; creatinine, p value = 0.007), lipid (total cholesterol, p value = 0.01; total triglycerides, p value = 0.03) and antioxidative (superoxide dismutase, p value = 0.005; glutathione, p value = 0.02; catalase, p value = 0.02) profile showed a highly significant difference among the studied groups specially patients with diabetes. Malondialdehyde (MDA) level had gone significantly up in diabetic TON patients (p value = 0.02), in comparison to other antioxidants and vitamins (Vit). Vit-A, E, B1, B12 and Zinc seem to be playing a major role in the pathogenesis of TON, specially Vit-E and B1 surpassed all the antioxidants as having highly significant inverse relationships with MDA (MDA vs Vit-E, r = -0.676(**) and MDA vs Vit-B1, r = -0.724(**) respectively). We conclude that during the ethambutol therapy the decreased levels of Vit-E and Vit-B1 possibly play a role in the development of TON and may be used as therapeutic agents to lessen the deleterious effects of ethambutol.
authors.affiliation: Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Rasool
authors.affiliation: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan.
authors.forename: Arif
authors.initials: A
authors.lastname: Malik
authors.affiliation: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Manan
authors.affiliation: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan.
authors.forename: Khuram
authors.initials: K
authors.lastname: Aziz
authors.affiliation: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan.
authors.forename: Amna
authors.initials: A
authors.lastname: Mahmood
authors.affiliation: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan.
authors.forename: Saima
authors.initials: S
authors.lastname: Zaheer
authors.affiliation: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan.
authors.forename: Naveed
authors.initials: N
authors.lastname: Shuja
authors.affiliation: Center for Research in Molecular Medicine (CRiMM), The University of Lahore, Lahore, Pakistan.
authors.forename: Mahmood Husain
authors.initials: MH
authors.lastname: Qazi
authors.affiliation: King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mohammad Amjad
authors.initials: MA
authors.lastname: Kamal
authors.affiliation: Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Sajjad
authors.initials: S
authors.lastname: Karim
keywords: ALP, alkaline phosphatase; ALT, alanine transaminase aspartate; CAT, catalase; Catalase; Diabetes; EMB, ethambutol; Ethambutol; GSH, glutathione; Glutathione; MDA, malondialdehyde; ROS, reactive oxygen species; SOD, superoxide dismutase; Superoxide dismutase; TON, toxic optic neuropathy; Toxic optic neuropathy; Vit, vitamins; Vitamins