Skip to main content

Prooxidant–antioxidant balance in patients with traumatic brain injury

Abstract

Brain trauma is an important cause of mortality and disability among young people worldwide. One of the mechanisms of post-traumatic secondary brain damage is related to free radical release and oxidative stress (OS). OS is the consequence of an imbalance between pro-oxidants and antioxidants in favor of pro-oxidants. This imbalance may lead to macromolecule damage including lipid peroxidation, protein crosslinking, DNA damage and changes in growth and function of cells in brain. Free radical release and subsequent lipid peroxidation are early events following neural tissues injury and are associated with hypo-perfusion, edema, and disruption of axonal guidance. In this study, we determined the prooxidant–antioxidant balance (PAB) in patients with brain injury, and its correlation with number of demographic and clinical parameters. Sera from 98 patients with traumatic brain and 100 healthy subjects were collected. The serum PAB was measured. Age, sex, GCS (Glasgow coma scale), mechanism of injury, brain lesions found on CT scan and lesions in other parts of the body, caused by trauma, were determined. A significantly higher PAB value was observed in the patient group (138.97 ± 15.9 HK unit) compared to the controls (60.82 ± 12.6 HK) (P = 0.001). In the patient group, there was no significant correlation of PAB with GCS, brain lesion characteristic, mechanism of injury, other accompanying traumatic injury, age and gender. When patients were classified into three groups according to GCS: group 1 (GCS>13, n = 28, PAB serum value = 138.51 ± 62.66 HK), group 2 (GCS between 8 and 12, n = 29, PAB serum value = 162.7 ± 50.6 HK) and group 3 (GCS <8, n = 41, PAB serum value = 155.56 ± 58.21 HK); there was no significant difference between groups. The serum PAB values were higher in patients with traumatic brain injury, although this was not associated with the extent of injury.

This is a preview of subscription content, access via your institution.

Fig. 1

Abbreviations

TOS:

Total oxidant status

FOX:

Ferrous ion oxidation xylenol orange

GCS:

Glasgow coma scale

PAB:

Prooxidant–antioxidant balance

TBI:

Traumatic brain injury

ROS:

Reactive oxygen species

References

  1. Freire MA (2012) Pathophysiology of neurodegeneration following traumatic brain injury. West Indian Med J 61:751–755

    CAS  PubMed  Google Scholar 

  2. Halliwell B (2006) Oxidative stress and neurodegeneration: where are we now? J Neurochem 97:1634–1658

    Article  CAS  PubMed  Google Scholar 

  3. Alamdari DH, Paletas K, Pegiou T, Sarigianni M, Befani C, Koliakos G (2007) A novel assay for the evaluation of the pro-oxidant–antioxidant balance, before and after antioxidant vitamin administration in type II diabetes patients. Clin Biochem 40:248–254

    Article  CAS  PubMed  Google Scholar 

  4. Delanty N, Dichter MA (1998) Oxidative injury in the nervous system. Acta Neurol Scand 98:145–153

    Article  CAS  PubMed  Google Scholar 

  5. Hussain SP, Hofseth LJ, Harris CC (2003) Radical causes of cancer. Nat Rev Cancer 3:276–285

    Article  CAS  PubMed  Google Scholar 

  6. Erel OA (2005) New automated colorimetric method for measuring total oxidant status. Clin Biochem 38:1103–11011

    Article  CAS  PubMed  Google Scholar 

  7. Erel O (2004) A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem 37:112–119

    Article  CAS  PubMed  Google Scholar 

  8. Alamdari DH, Ghayour-Mobarhan M, Tavallaie S, Parizadeh MR, Moohebati M, Ghafoori F et al (2007) Prooxidant–antioxidant balance as a new risk factor in patients with angiographically defined coronary artery disease. Clin Biochem 41:375–380

    Article  PubMed  Google Scholar 

  9. Werner C, Engelhard K (2007) Pathophysiology of traumatic brain injury. Br J Anaesth 99:4–9

    Article  CAS  PubMed  Google Scholar 

  10. Hall ED, Vaishnav RA, Mustafa AG (2010) Antioxidant therapies for traumatic brain injury. Neurotherapeutics 7:51–61

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Ramana KV (2011) ALDOSE REDUCTASE: new insights for an old enzyme. Biomol Concepts 2:103–114

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Han SN, Meydani SN (2000) Antioxidants, cytokines, and influenza infection in aged mice and elderly humans. J Infect Dis 182 Suppl 1:74–80

    Article  Google Scholar 

  13. Shohami E, Beit-Yannai E, Horowitz M, Kohen R (1997) Oxidative stress in closed-head injury: brain antioxidant capacity as an indicator of functional outcome. J Cereb Blood Flow Metab 17:1007–1019

    Article  CAS  PubMed  Google Scholar 

  14. Eghwrudjakpor PO, Allison A (2010) Oxidative stress following traumatic brain injury: enhancement of endogenous antioxidant defence system and the promise of improved outcome. Nig J Med 19:14–21

    Article  CAS  Google Scholar 

  15. Razmkon A, Sadidi A, Sherafat-Kazemzadeh E, Mehrafshan A, Jamali M, Malekpour B, Saghafinia M (2011) Administration of vitamin C and vitamin E in severe head injury: a randomized double-blind controlled trial. Clin Neurosurg 58:133–137

    Article  PubMed  Google Scholar 

  16. Nayak CD, Nayak DM, Raja A, Rao A (2008) Erythrocyte indicators of oxidative changes in patients with graded traumatic head injury. Neurol India 56:31–35

    Article  PubMed  Google Scholar 

  17. Hanafy KA, Selim MH (2012) Antioxidant strategies in neurocritical care. Neurotherapeutics 9:44–55

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daryoush Hamidi Alamdari.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Ehsaei, M., Khajavi, M., Arjmand, M.H. et al. Prooxidant–antioxidant balance in patients with traumatic brain injury. Acta Neurol Belg 115, 69–73 (2015). https://doi.org/10.1007/s13760-014-0300-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-014-0300-4

Keywords

  • Prooxidant-antioxidant balance
  • Trumatic brain injury
  • Oxidative stress