I think that we will see an increasing use of biomarkers of oxidative stress to support clinical decisions.
Dr Cooke said that idiopathic pulmonary haemosiderosis is a devastating condition. Characteristic of this condition is the accumulation of protein-bound iron in the lungs, a consequence of repeated bleeding in the lungs, coupled with inflammation and fibrosis. Ultimately this condition is usually fatal. Treatment to prevent the lung damage and prevent anaemia is a combination of corticosteroids and iron supplement.
Both chronic inflammation, and the presence of iron, released following bleeding into the lungs, can lead to a condition known as oxidative stress. Oxidative stress occurs when the production of free radicals, highly reactive chemicals, outweighs antioxidant defences. This leads to a great deal of damage to cells, and in particular DNA, the cells blueprint, and is likely to be responsible for the fibrosis, as the lungs try to repair the damage done by free radicals.
In order to establish whether oxidative stress was indeed associated with episodes of bleeding into the lungs, we measured a biomarker of oxidative stress, and a marker of damage to DNA specifically, in urine.
We noted that levels of oxidative stress increased significantly following every bleed. With this in mind, and on the basis that antioxidants can potentially boost the bodys natural defences, we began the patient on a course of the antioxidant drug N-acetyl cysteine. Five months into antioxidant therapy, the patient remains clinically well, and on a reduced dose of corticosteroids.
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Contact: Dr. Marcus Cooke
44-011-625-2825
University of Leicester
1-Jun-2007