Blood Res 2016; 51(4): 261-267  https://doi.org/10.5045/br.2016.51.4.261
Effect of short-term, high-dose methylprednisolone on oxidative stress in children with acute immune thrombocytopenia
Musa Cura1, Ahmet Koç2, Nurten Aksoy3, Zeynep Canan Özdemir4
1Department of Pediatrics, Harran University Medical Faculty, Sanliurfa, 2Department of Pediatric Hematology/Oncology, Marmara University Faculty of Medicine, Istanbul, 3Department of Clinical Biochemistry, Harran University Medical Faculty, Sanliurfa, 4Department of Pediatric Hematology/Oncology, Eskişehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
Correspondence to: Zeynep Canan Özdemir, M.D.
Department of Pediatric Hematology/Oncology, Eskişehir Osmangazi University Faculty of Medicine, 26480, Eskişehir, Turkey
E-mail: efecanan@yahoo.com
Received: April 26, 2016; Revised: July 22, 2016; Accepted: September 22, 2016; Published online: December 31, 2016.
© The Korean Journal of Hematology. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Immune thrombocytopenia (ITP) is the most common cause of acquired childhood thrombocytopenia and is characterized by increased immune-mediated destruction of circulating thrombocytes. Oxidative damage may be involved in ITP pathogenesis; paraoxonase (PON) and arylesterase (ARE) enzymes are closely associated with the cellular antioxidant system. We investigated the effect of short-term high-dose methylprednisolone (HDMP) treatment on the total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and PON and ARE enzymatic activity in children with acute ITP.
Methods
Thirty children with acute ITP constituted the study group and 30 healthy children constituted the control group. Children with acute ITP were treated with HDMP: 30 mg/kg for 3 days, then 20 mg/kg for 4 days. The TOS, TAC, OSI, PON, and ARE levels were determined before and after 7 days of HDMP treatment.
Results
The TAC level (P<0.001), and PON (P<0.001) and ARE (P=0.001) activities were lower and the TOS (P=0.003) and OSI (P<0.001) levels were higher in children with acute ITP than those in healthy children in the control group. We also observed statistically significant increases in the TAC (P<0.01), PON (P<0.001) and ARE levels (P=0.001) and decreases in the TOS (P<0.05) and OSI levels (P<0.05) with 7 days of HDMP treatment compared to their values before treatment.
Conclusion
Our study demonstrated increased oxidative stress (OSI and TOC) and decreased antioxidant capacity (TAC), PON, and ARE in ITP patients and that steroid treatment could be effective in reducing the oxidative stress.
Keywords: ITP, Paraoxonase, Arylesterase, Child, Methylprednisolone


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