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Abstract
Ten adult patients (three male, age range, 15 to 67 years) with established ARDS were
studied for serial changes in the proteinaceous antioxidant activities of their plasma.
All had LISs in excess of 2.5 on admission to the study. Blood samples were taken
as soon as possible after the diagnosis of ARDS, and from 10 patients at risk of developing
ARDS. These were compared with healthy control subjects. Deoxyribose, phospholipids,
and DNA were used as markers of damage in reactions generating inorganic and organic
oxygen radicals and an oxo-iron species. The ability of plasma to inhibit such damage
was expressed as antioxidant activity. This study does not address the clinical problem
of why certain “at risk” patients develop ARDS, but rather the question of why some
patients with established ARDS are better able than others to survive the disease.
ARDS patients had transferrin levels that were significantly lower (1.76 ± 0.13 gm/L)
than those of normal controls (2.91 ± 0.12 gm/L, p < 0.001), which decreased the ability of their plasma to protect phospholipid membranes
and DNA against iron-stimulated free radical damage. The iron-oxidizing antioxidant
properties of plasma were mainly dependent on the protein ceruloplasmln, concentrations
of which were significantly higher in ARDS patients (0.387 ± 0.04 gm/L) than in healthy
controls (0.265 ± 0.03 gm/L, p = < 0.05) or patients at risk of ARDS (0.24 ± 0.04 gm/L, p = < 0.05). The iron-oxidizing (ferroxidase) antioxidant activities of plasma from
ARDS patients, however, were similar to those of both control groups. Measurement
of plasma ferroxidase activities confirmed that although more ceruloplasmin was present
in the plasma of ARDS patients, enzyme activities were comparable to those of both
control groups, which was suggestive of a loss of ceruloplasmin ferroxidase activity.
Scavenging and radical-stimulating properties of plasma (devoid of ironbinding and
iron-oxidizing properties) was partly dependent on protein thiol groups, which were
lower in ARDS patients and in patients at risk of developing ARDS. Serial sample analysis
revealed that ARDS patients showed substantial daily variations in biochemical parameters,
implying that single time-point sampling may be unsuitable when studying these patients.
Abbreviations:
ARDS (adult respiratory distress syndrome), BAL (bronchoalveolar lavage fluid), Fio2 (inspired oxygen concentration), H2O2 (hydrogen peroxide), HOCI (hypochlorus acid), LIS (lung injury score), ICU (intensive care unit), LO (lipid alkoxyl radical), LO2 (lipid peroxyl radical)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
February 18,
1994
Received in revised form:
February 15,
1994
Received:
August 20,
1993
Footnotes
☆Supported by the British Oxygen Group plc, the British Lung Foundation, and the Wellcome Trust.
Identification
Copyright
© 1994 Published by Elsevier Inc.
