|Year : 2018 | Volume
| Issue : 1 | Page : 36-39
Oxidative stress markers in senile cataract and primary open-angle glaucoma
Waled M Nada MD 1, Doaa A Abdel Moety2
1 Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2 Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
|Date of Submission||26-Apr-2017|
|Date of Acceptance||25-Aug-2017|
|Date of Web Publication||1-Feb-2018|
Waled M Nada
Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, 44523
Source of Support: None, Conflict of Interest: None
This study aimed at the evaluation of the role of oxidative stress markers such as superoxide dismutase (SOD), malondialdehyde (MDA), and catalase activity in senile cataract and primary open-angle glaucoma (POAG) to allow for modification and updating the management of such cases.
Patients and methods
This is an observational case–control study. The study included 60 participants divided into three equal groups: group A (20 normal persons) as the control group, group B (20 patients with untreated POAG; newly diagnosed), and group C (20 patients with senile cataract). Serum oxidative stress markers were measured in all groups and statistical analysis of data was performed.
In comparison with the control group, serum SOD increased significantly in group B patients with POAG (2.11±0.3 U/ml, P<0.001) and insignificantly in group C patients with senile cataract (1.01±0.18 U/ml, P>0.05). In addition, serum MDA increased significantly in group B patients with POAG (4.12±0.81 nmol/ml, P<0.001), whereas no significant changes were noticed in group C patients with senile cataract (2.74±0.64 nmol/ml, P>0.05). Serum catalase activity decreased significantly in group B patients with POAG (16.24±3.25 U/ml, P<0.001), with no significant changes in group C patients with senile cataract (21.77±4.17 U/ml, P>0.05).
Oxidative stress markers had a significant role in the pathogenesis of POAG and had no role in senile cataract. MDA increased significantly in cases of POAG, and antioxidant activity (except SOD) decreased in such cases and were not changed in cases of senile cataract, indicating the importance of the addition of antioxidative therapy in conjunction with the medical treatment of POAG.
Keywords: catalase activity, malondialdehyde, oxidative stress markers, primary open-angle glaucoma, senile cataract, superoxide dismutase
|How to cite this article:|
Nada WM, Abdel Moety DA. Oxidative stress markers in senile cataract and primary open-angle glaucoma. Delta J Ophthalmol 2018;19:36-9
|How to cite this URL:|
Nada WM, Abdel Moety DA. Oxidative stress markers in senile cataract and primary open-angle glaucoma. Delta J Ophthalmol [serial online] 2018 [cited 2018 Feb 24];19:36-9. Available from: http://www.djo.eg.net/text.asp?2018/19/1/36/224561
| Introduction|| |
Oxidative stress plays an important role in different diseases. Management of such diseases may be related to the stress condition especially in cases of primary open-angle glaucoma (POAG). The pathogenesis of POAG is still not clear. Intraocular pressure (IOP) is the most famous known risk factor, but in some situations control of IOP does not stop the progression of the disease. Many other factors may be responsible for the pathogenesis of POAG such as oxidative stress, inflammatory factors, and the progression of cell apoptosis mechanism ,,,.
Senile cataract is considered one of the degenerative diseases that may be related to stress conditions, antioxidant status, and free radicals. Many oxidative stress markers such as ceruloplasmin (a protein incorporated in iron homeostasis) and superoxidase dismutase (SOD) are considered biomarkers that play an important role in the inactivation of free radicals. Monitoring of these markers can be highly beneficial in the determination of oxidative stress status in the body and hence prevention and modulation of treatment of many related diseases ,,.
In POAG, oxidative stress may increase the permeability of the blood–ocular barrier ,. Malondialdehyde (MDA) and catalase (CAT) activity are considered important markers contributing to the oxidative stress affecting many systems in the body and in relation to multiple degenerative diseases . Multiple studies recommended the administration of antioxidative therapy in conjunction with medical treatment of different oxidative-stress-related diseases such as glaucoma and other degenerative diseases ,,,.
The present study aimed at the evaluation of the role of oxidative stress markers such as SOD, MDA, and catalase activity (CAT) in senile cataract and POAG to allow for modification and updating the management of such cases.
| Patients and methods|| |
This observational case–control study was performed in Ophthalmology Department, Zagazig University, in the period from October 2015 to October 2016. The study was performed according to World Medical Association Declaration of Helsinki − Ethical Principles for Medical Research Involving Human Subjects. The protocol of the study was approved by the Ethical Committee of the Faculty of Medicine, Zagazig University. Informed consent was obtained from the participants. The study included 60 participants divided into three equal groups.
The criteria in the control group A were as follows:
- Age from 45 to 65 years.
- Equal male and female ratio.
- Nonglaucomatous persons, depending on measuring IOP by applanation tonometer, optic disc evaluation by fundus examination, and normal optic nerve fiber layer thickness by optical coherence topography (OCT) using RS-3000 Lite OCT machine (NIDEK Co. Ltd, Gamagori, Japan) (OCT Glaucoma study), according to Wu et al. .
- No degenerative ocular conditions such as cataract or inflammatory conditions.
- Free of systemic diseases such as diabetes or hypertension or systemic degenerative diseases.
The criteria for selection of group B:
The criteria were the same as those in group A, except that they had POAG (newly diagnosed). The diagnosis of POAG was based on the clinical examination by measuring IOP (by applanation tonometer) more than 24 mmHg, optic nerve evaluation by direct fundus examination either normal or increase in cup disc ratio, abnormal visual field test using Humphrey Field Analyzer (Model 745; Carl Zeiss GmbH, Jena, Germany), and abnormal thinning of nerve fiber layer thickness by OCT.
The criteria for selection of group C:
The criteria were the same as those in group A, except that they had senile cataract either unilateral or bilateral with different stages.
Venous blood samples were collected. Serum was separated and the following parameters were measured:
- SOD was measured using SOD Assay Kit (item No.706222; Cayman Chemicals, Ann Arbor, Michigan, USA) with a sensitivity of 0.005 U/ml.
- MDA was measured using Lipid Peroxidation (MDA) Assay Kit (colorimetric/fluorometric) in nmol/ml (ab118970; Abcam, Cambridge, Massachusetts, USA).
- CAT was measured using CAT Assay Kit (item no. 707002; Cayman Chemicals), with a sensitivity of 2 U/ml.
Statistical analysis of data was performed using one-way analysis of variance with determination of P value. P value less than 0.05 was considered to be moderately significant, P value less than 0.001 was highly significant, and P value more than 0.05 was insignificant. In addition, correlation coefficient was performed (Pearson’s correlation coefficient calculator) with determination of r and P values.
| Results|| |
In the control group A, the age ranged from 45 to 65 years with a mean age of 54.3±5.18 years. In group B patients with POAG, it ranged from 46 to 66 years with a mean age of 53.27±6.66 years, whereas in group C patients with senile cataract it ranged from 51 to 68 years with a mean age of 55.8±6.16 years. Male-to-female ratio was 1 in all groups.
Serum SOD in the control group A was 0.93±0.5 U/ml, whereas in group B patients with untreated POAG it was significantly higher (2.11±0.3 U/ml, P<0.001) and was not significantly different in group C patients with senile cataract (1.01±0.18 U/ml, P>0.05).
Serum MDA in the control group A was 2.63±0.52 nmol/ml, whereas in group B patients with POAG it was significantly higher (4.12±0.81 nmol/ml, P<0.001) and was not significantly different in group C patients with senile cataract (2.74±0.64 nmol/ml, P>0.05).
Serum CAT in the control group A was 20.28±4.12 U/ml, whereas in group B patients with POAG it was significantly lower (16.24±3.25 U/ml, P<0.001) and insignificantly higher in group C patients with senile cataract (21.77±4.17 U/ml, P>0.05), as shown in [Table 1].
A negative correlation was found between serum catalase and SOD levels in group B (r=0.539, P=0.002). Serum catalase level was negatively correlated with serum level of MDA in group B (r=−0.690, P=0.000). On the other hand, a positive correlation was observed between serum MDA and SOD levels in group B (r=0.596, P=0.001). No correlations were reported between serum catalase level and each of serum SOD and MDA levels in groups A and C ([Table 2]).
|Table 2: Correlations between serum catalase levels, superoxide dismutase, and malondialdehyde in all groups|
Click here to view
| Discussion|| |
The pathogenesis of senile cataract is well known, but that of POAG is still under investigation. Many risk factors were incriminated in the process of POAG such as IOP, vascular perfusion for retinal nerve fiber layer, retinal ganglion cell degenerations, and optic neuropathic mechanisms. Majsterek et al.  and Mumcu et al.  stated that the pathogenesis of POAG may be related to oxidative stress, inflammatory factors, and characteristic pattern of cell death by apoptosis. The present study was performed for evaluation of these contributing factors in POAG and senile cataract.
In the present study, serum CAT decreased significantly in group B patients with POAG (16.24±3.25 U/ml), whereas no significant changes were observed in group C patients with senile cataract (21.77±4.17 U/ml). This result was in agreement with the study by Majsterek et al. , who stated that antioxidant activity decreased in POAG recommending for adding antioxidant agents in management of cases of POAG for ganglion cell survival and modulation of cell apoptosis in such cases.
The present study reported that serum SOD increased significantly in group B patients with POAG, with no significant change in group C patients with senile cataract in comparison with the control group. This was in agreement with the study by Erdurmuş et al. , who reported the same results, in addition to Ghanem et al. , who reported that SOD increased significantly in aqueous humor in patients with POAG.
In the present study, serum MDA increased significantly in group B patients with POAG (4.12±0.81 nmol/ml), with no significant change in group C patients with senile cataract (2.74±0.64 nmol/ml), which was in agreement with the study by Mumcu et al. , who stated that MDA increased in cases of POAG as an oxidative stress biomarker. The present study and many studies were in agreement that there were negative correlations between serum catalase and SOD and MDA levels in patients with POAG.
| Conclusion|| |
Oxidative stress markers had a significant role in the pathogenesis of POAG. On the other hand, they had no role in the pathogenesis of senile cataract. As MDA increased significantly in cases of POAG, while antioxidant activity in the form of CAT (and not SOD) decreased in such cases and was not changed in cases of senile cataract, it is recommended to add antioxidative therapy in conjunction with the medical treatment of POAG.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Sena DF, Ramchand K, Lindsley K. Neuroprotection for treatment of glaucoma in adults. Cochrane Database Syst Rev 2010; 2:CD006539.
Neamatzadeh H, Soleimanizad R, Zare-Shehneh M, Gharibi S, Shekari A, Rahimzadeh AB. Association between p53 codon 72 (Arg72Pro) polymorphism and primary open-angle glaucoma in Iranian patients. Iran Biomed J 2015; 19:51–56.
Vohra R, Tsai JC, Kolko M. The role of inflammation in the pathogenesis of glaucoma. Surv Ophthalmol 2013; 58:311–320.
Anholt RR, Carbone MA. A. molecular mechanism for glaucoma: endoplasmic reticulum stress and the unfolded protein response. Trends Mol Med 2013; 19:586–593.
He X, Hahn P, Iacovelli J, Wong R, King C, Bhisitkul R et al.
Iron homeostasis and toxicity in retinal degeneration. Prog Retin Eye Res 2007; 26:649–673.
Osaki S, Johnson DA, Frieden E. The possible significance of the ferrous oxidase activity of ceruloplasmin in normal human serum. J Biol Chem 1966; 241:2746–2751.
Goldstein IM, Kaplan HB, Edelson HS, Weissmann G. Ceruloplasmin: an acute phase reactant that scavenges oxygen-derived free radicals. Ann N Y Acad Sci 1982; 389:368–379.
Kuryshova NI, Vinetskaia MI, Erichev VP, Artamonov VP, Uspenskaia AP. Permeability of blood-aqueous humor barrier in primary open-angle glaucoma. Vestn Oftalmol 1998; 114:10–13.
Miyahara T, Kikuchi T, Akimoto M, Kurokawa T, Shibuki H, Yoshimura N. Gene microarray analysis of experimental glaucomatous retina from cynomologous monkey. Invest Ophthalmol Vis Sci 2003; 44:4347–4356.
Sarnat-Kucharczyk M, Rokicki W, Zalejska-Fiolka J, Pojda-Wilczek D, Mrukwa-Kominek E. Determination of serum ceruloplasmin concentration in patients with primary open angle glaucoma with cataract and patients with cataract only: a pilot study. Med Sci Monit 2016; 25:1384–1388.
Erdurmuş M, Yağcı R, Atış Ö, Karadağ R, Akbaş A, Hepşen IF. Antioxidant status and oxidative stress in primary open angle glaucoma and pseudoexfoliative glaucoma. Curr Eye Res 2011; 36:713–718.
Rokicki W, Zalejska-Fiolka J, Pojda-Wilczek D, Kabiesz A, Majewski W. Oxidative stress in the red blood cells of patients with primary open-angle glaucoma. Clin Hemorheol Microcirc 2016; 62:369–378.
Mumcu UY, Kocer I, Ates O, Alp HH. Decreased paraoxonase1 activity and increased malondialdehyde and oxidative DNA damage levels in primary open angle glaucoma. Int J Ophthalmol 2016; 9:1518–1520.
Majsterek I, Malinowska K, Stanczyk M, Kowalski M, Blaszczyk J, Kurowska AK et al.
Evaluation of oxidative stress markers in pathogenesis of primary open-angle glaucoma. Exp Mol Pathol 2011; 90:231–237.
Wu Z, Saunders LJ, Zangwill LM, Daga FB, Crowston JG, Medeiros FA. Impact of normal aging and progression definitions on the specificity of detecting retinal nerve fiber layer thinning. Am J Ophthalmol 2017; 29:30262–30263.
Ghanem AA, Arafa LF, El-Baz A. Oxidative stress markers in patients with primary open angle glaucoma. Curr Eye Res 2010; 35:295–301.
[Table 1], [Table 2]