Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 131749

AbstractMaterial and MethodsResultsDiscussionConclusionAcknowledgementReferences
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2010 | Month : August | Volume : 4 | Issue : 4 | Page : 2742 - 2747 Full Version

Antioxidant Vitamins And Enzymes Status In Patients With Alcoholic Liver Disease.


Published: August 1, 2010 | DOI: https://doi.org/10.7860/JCDR/2010/.809
JANANI A V* and SURAPANENI K M**

*2nd Year Medical Student, Saveetha Medical College & Hospital, Saveetha University, Saveetha Nagar, Thandalam, Chennai – 602 105, Tamilnadu, INDIA. **Assistant Professor, Department of Biochemistry, Saveetha Medical College & Hospital, Saveetha University, Saveetha Nagar, Thandalam, Chennai – 602 105, Tamilnadu, INDIA.

Correspondence Address :
Surapaneni Krishna Mohan,
Assistant Professor,
Department of Biochemistry,
Saveetha Medical College & Hospital,
Saveetha University, Saveetha Nagar,
Thandalam, Chennai – 602 105, Tamilnadu, INDIA.
E-mail: krishnamohan_surapaneni@yahoo.com

Abstract

OBJECTIVES: The exact pro-oxidant and antioxidant status in alcoholic liver disease among the chronic alcoholics is still not clear. Consumption of excess amounts of ethanol causes liver damage by several mechanisms. Chronic alcohol consumption is associated with increased incidence of variety of illnesses including cirrhosis. Studies have shown that ethanol consumption may result in increased oxidative stress with increased formation of lipid peroxides and free radicals.
METHODS: To add a new insight to the question, changes in the levels of antioxidant vitamins ascorbic acid and plasma vitamin E (non enzymatic antioxidant parameters) and activities of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase in erythrocytes were measured in 30 patients with alcoholic liver disease (study subjects) and compared to 30 age and sex matched healthy subjects (controls). Statistical analysis between controls and patients was performed by the unpaired t-test using the SPSS package
RESULTS: It was observed that there was a significant increase in the activities of SOD and GPx and a significant decrease in erythrocyte ascorbic acid, plasma vitamin E levels and catalase activity in patients with alcoholic liver disease, among chronic alcoholics when compared to controls.
CONCLUSIONS: The results of our study have shown higher oxygen free radical production, evidenced by the decreased levels of ascorbic acid, vitamin E and catalase activity, supporting the hypothesis that there is increased oxidative stress in patients with alcoholic liver disease. The increased activities of antioxidant enzymes may be a compensatory regulation in response to increased oxidative stress. The decreased concentrations of the antioxidant vitamin status support the hypothesis that lipid peroxidation is an important causative factor in the pathogenesis of alcoholic liver disease among chronic alcoholics. These data reveal that antioxidant defense mechanisms might be impaired in these patients. These findings also provide a theoretical basis for the development of novel therapeutic strategies, such as antioxidant supplementation.

Keywords

Alcoholic liver disease, ascorbic acid, vitamin E, superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase, alcoholic liver disease.

INTRODUCTION
Alcoholic Liver Disease (ALD) is the disease considered to be a major cause of morbidity and mortality, with increasing incidence day by day especially in the developing countries including India (1). This disease is induced / caused due to the consumption of excess alcohol. Chronic consumption of alcohol causes accumulation of the fatty acids in hepatocytes thereby decreasing the functional capacity of the liver (2). The ingested alcohol in chronic alcoholics also alters various metabolic pathways inside the liver (3) (4) which ultimately leads to the production of the reactive oxygen species (ROS) (5). Lipid peroxidation mediated by free radicals is considered to be the major mechanism of cell membrane destruction and cell damage (6). Free radicals are formed in both physiological and pathological conditions in mammalian tissues (7). The uncontrolled production of free radicals is considered as an important factor in the tissue damage induced by several pathophysiologies (8). Influence of free radicals and presence of oxidative damage that is alteration in the oxidant -antioxidant profile is known to occur in chronic alcoholism (9)(10). Oxidative stress due to damage brought about by free radicals is also known to influence the response of these patients to therapy. Moreover the body’s defense mechanisms would play a role in the form of antioxidants and try to minimize the damage, adapting itself to the above stressful situation. Antioxidants are compounds that dispose, scavenge, and suppress the formation of free radicals, or oppose their actions (11) and two main categories of antioxidants are those whose role is to prevent the generation of free radicals and those that intercept any free radicals that are generated (12) They exist in both the aqueous and membrane compartment of cells and can be enzymes or non-enzymes.
In our previous study we showed that lipid peroxidation was significantly increased along with the significant decrease in glutathione levels in chronic alcoholics with alcoholic liver disease (13). However the antioxidant vitamins and antioxidant enzyme status was not assessed. Therefore in this study, concentrations of antioxidant vitamins along with the activities of antioxidant enzymes were estimated in patients with alcoholic liver disease and compared to controls.
In the present study, the following parameters were assessed in the erythrocytes and plasma to elucidate the oxidant–antioxidant status in chronic alcoholics with alcoholic liver disease. Erythrocyte ascorbic acid and plasma vitamin E levels were estimated along with the activities of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx) in erythrocytes as an index of antioxidant status. Malondialdehyde (MDA) levels were measured as thiobarbituric acid-reacting substances (TBARS), which serve as an index of extent of lipid peroxidation. The activity of the enzyme catalase was also measured. These parameters were estimated in RBCs to assess the disturbances in oxidant–antioxidant status and their effect on erythrocytes. Alterations in antioxidant enzymes have been reported in various studies (14).

Material and Methods

The study was conducted in the Department of Biochemistry, Saveetha Medical College and Hospital, Saveetha University, Chennai, T.N, India. Thirty male patients of alcoholic liver disease established on accepted clinical biochemical criteria (15) were chosen for the study. An equal number of age matched healthy subjects were also investigated. The control and patient groups had the same socioeconomic background. Therefore, changes in analytes due to nutritional factors are minimal. Written consents were also taken from the patients prior to the study. The controls chosen for the study were non alcoholic healthy individuals of similar age group without liver disease, obesity and any other inflammatory disease. Patients suffering from disease of any origin other than alcohol intake were excluded from the study. Patients were subjected to detailed clinical examination and laboratory investigations. The Controls and patients were divided into 2 groups.
Group 1: Thirty healthy age matched controls.
Group 2: Thirty patients with alcoholic liver disease.
The venous blood samples obtained from these subjects were used for the estimation of ascorbic acid, SOD, GPx, catalase and MDA in erythrocytes and vitamin E in plasma. The venous blood samples obtained under asceptic conditions, from these subjects in fasting state were used for the analysis. Plasma was separated by centrifugation at 1,000 g for 15 minutes. Separated plasma was used for the measurement of the activity of vitamin E. Ascorbic acid levels were estimated in plasma by the method of Tietz (16). Plasma vitamin E levels were estimated by the method of Baker H et al (17). SOD (EC 1.15.1.1) activity was determined in the hemolysate by the method of Marklund & Marklund (18). Catalase (EC 1.11.1.6) activity was measured by the method of Beers and Sizer (19). The activity of Glutathione Peroxidase (GPx, EC 1.11.1.9) was measured as described by Paglia and Valentine (20) in erythrocytes All reagents used were of analytical reagent grade and were obtained form Sigma Chemicals, St. Louis, MO.
STATISTICAL ANALYSIS:
Statistical analysis between group 1 (controls) and group 2 (study subjects) was performed by the student t-test using the SPSS package for windows. The data were expressed as mean + SD. p < 0.05 was considered as significant.

Results

The mean + SD of antioxidant vitamins –ascorbic acid and vitamin E in controls and patients with Alcoholic Liver Disease are indicated in the (Table/Fig 1).(Table/Fig 1) shows that these antioxidant vitamins were significantly decreased in patients with alcoholic liver disease as compared to controls.
The mean + SD of erythrocyte SOD, GPx and Catalase are indicated in (Table/Fig 2) and (Table/Fig 3). There was a statistically significant increase in the erythrocyte antioxidant enzymes – SOD, GPx activity in patients with alcoholic liver disease as compared to controls. The level of erythrocyte catalase activity was significantly decreased in group 2 (study subjects) compared to group1 (controls).

Discussion

In our study we have observed that, there was a significantly lower level of antioxidant vitamins and increased activity of antioxidant enzymes in patients with alcoholic liver disease compared to controls.
We observed a significant decrease in the levels of erythrocyte ascorbic acid, and plasma vitamin E (non enzymatic antioxidant defense system) in patients with alcoholic liver disease when compared to controls. Free radical generation can induce oxidative stress. The decrease in the levels of these non enzymatic antioxidant vitamin parameters may be due to the increased turnover, for preventing oxidative damage in these patients suggesting an increased defense against oxidant damage in alcoholic liver disease. Similar reports of decreased antioxidant vitamins levels in chronic alcoholics with alcoholic liver disease reported by various studies (2) (21). These findings were supported by our earlier study (13), in which a significant reduction in the levels of glutathione and significant decrease in glutathione – S - transferase activity were observed in chronic alcoholics with alcoholic liver disease compared to controls. A marked increase in lipid peroxidation in these patients was also noted. These results indicate that in ALD patients the efficiency of the antioxidant vitamins in counteracting the damaging effects of free radicals is significantly reduced. Thus the results of our present study suggest that a cumulative functional insufficiency of the antioxidant vitamin system may play an essential role in the development of oxidative stress in patients with alcoholic liver disease.
The levels of erythrocyte MDA were significantly higher in chronic alcoholics with alcoholic liver disease as compared to controls as reported by our earlier study (13). In chronic alcoholics, the chronic consumption of alcohol causes the excessive accumulation of fatty acids in hepatocytes there by causing damage to the liver by decreasing its functional capacity (21). It has been postulated that alcohol damage to liver can be mediated through the action of toxic oxygen radicals generated by ethanol, one among the other factors (22) (23). It is also postulated that ethanol induces cytochrome P450 2E1 there by causing generation of excess ROS leading to the production of oxidative stress (24). On the other hand acetaldehyde the metabolic end product of the ethanol oxidation by alcohol dehydrogenase or by cytochromes causes the consumption of antioxidants and inactivation of antioxidants and responsible for the increased generation of free radicals (25).
In our study the erythrocyte Antioxidant enzyme, i.e. Super Oxide Dismutase (SOD) & Glutathione Peroxidase (GPx) activities have been increased significantly in patients with alcoholic liver disease. Similar reports of raised SOD & GPX activities have been reported in patients with alcoholic liver disease (26). SOD is the important antioxidant enzyme having an antitoxic effect against super oxide anion. The over expression of SOD might be an adaptive response and it results in increased dismutation of superoxide to hydrogen peroxide. GPX, an oxidative stress inducible enzyme plays a significant role in the peroxyl scavenging mechanism and in maintaining functional integration of the cell membranes (27). The rise in the activity of GPX could be due to its induction to counter the effect of increased oxidative stress. GPx provides an effective protective mechanism against cytosolic injury, because it eliminates H2O2 and lipid peroxides by reduction, utilising GSH (28).
In the present study, we have observed a significant decrease in the catalase activity in patients with alcoholic liver disease compared to controls. Catalase is the enzyme which protects the cells from the accumulation of hydrogen peroxide by dismutating it to form water and oxygen or by using it as an oxidant in which it works as a peroxidase (29). Similar reports of decreased catalase activity were observed in alcholic liver disease patients by Das et al (30).

Conclusion

In Conclusion, Oxidative stress may be involved in chronic alcoholics. The results of our study have shown higher oxygen free radical production, evidenced by increased levels of MDA and decreased levels of ascorbic acid, vitamin E and catalase activity, supporting the hypothesis that there is increased oxidative stress in patients with alcoholic liver disease. The increased activities of antioxidant enzymes may be a compensatory regulation in response to increased oxidative stress. The decreased concentrations of the antioxidant vitamin status support the hypothesis that lipid peroxidation is an important causative factor in the pathogenesis of alcoholic liver disease among chronic alcoholics. These data reveal that antioxidant defense mechanisms might be impaired in these patients. These findings also provide a theoretical basis for the development of novel therapeutic strategies, such as antioxidant vitamin supplementation.
Our results suggest the necessity for therapeutic co-administration of antioxidant vitamins along with conventional drugs to such patients with alcoholic liver disease in the initial stages to prevent the oxidative damage and deterioration of the tissues. The findings implicate oxidative stress in the disease and cite the biochemical rationale for clinical trials of antioxidants to prevent and treat alcoholic liver disease. However due to the limited number of cases included in this study, more studies may be required to substantiate the results and arrive at a definite conclusion in terms of safety and efficacy of adding antioxidant therapy as secondary therapy for the treatment of alcoholic liver disease.

Acknowledgement

This work was presented as a paper presentation (Oral presentation) in 2nd International Student Medical Congress in Kosice (ISMCK) held on June 21st – 27th, 2010 in Kosice, Slovakia.
The Authors are very much thankful to Dr.S.Porchelvan, M.Sc.,M.B.A.,PGDCA.,PhD., Professor in Biostatistics for assisting us in performing the statistical analyses.

References

1. Seema Gupta, Rajesh Pandey, Ranjan Katyal, H.K.Aggarwal, R.P.Aggarwal, and S.K.Aggarwal. Lipidperoxide and antioxidant status in alcoholic liver disease. Indian Journal of Clinical Biochemistry. 2005; 20 (1): 67 – 71. 2. Lieber C.S. Alcohol and liver: metabolism of alcohol and its role in hepatic and extrahepatic diseases. J.Med. 2000; 67(1): 84-94. 3. Hirnwich, H.E., Nahum, L.H., Pakieten, N., Fazekas, J.F., D U Bots, H. Effects of alcohol on metabolism. American Joural of Physiology. 1982; 101: 57 – 68. 4. Frienhel, N., Aky, R.A., Singer, D.L., Cohen, A.K. Alcohol hypoglycemia IV. Current concepts of its pathogenesis. Diabetes. 1985; 4: 350 – 361. 5. Lieber CS. Biochemical and molecular basis of alcohol induced injury to liver and other tissues. New England Journal of Medicine. 1988; 319: 1639–1650. 6. Datla, K., Sinha, S., Chattopadhyay, P. Reactive oxygen species in health & disease. Natl.Med.J.Ind. 2000; 13 (6): 305 – 311. 7. Tas F, Hansel H, Belce A, Ilvan S, argon A, Camlica H, Topuz E. “Oxidative stress in ovarian cancer”, Med. Oncol, 2005; 22(1), pp.11-15. 8. Yeh CC, Hou MF, Tsai SM, Lin SK, Hsiao JK, Huang JC, Wang LH, Wu SH, Hou LA, Ma H, Tsai LY. “Superoxide anion radical, lipid peroxides and antioxidant status in the blood of patients with ovarian cancer”, Clin Chim Acta. 2005; Nov, 381(1-2), pp.104 –11. 9. Albano E. Alcohol, oxidative stress and free radical damage. Proc. Nutr. Soc. 2006; 65: 278 – 290. 10. Lieber C.S. Role of oxidative stress and antioxidant therapy in alcoholic and non alcoholic liver diseases. Adv. Pharmacol. 1997; 38: 601 – 628. 11. Sie H. “Oxidative stress: from basic research to clinical application”, Am J Med. 1988; 9, pp.31-38. 12. Cotgreave I, Moldeus P, Orrenius S. “Host biochemical defense mechanisms against prooxidants”, Annu Rev Pharmacol Toxicol, 1988; 28, pp.189-212. 13. Maithreyi R, Janani AV, Krishna R, Shweta A, Rufus Ranjitsingh Edwin, Surapaneni Krishna Mohan. Erythrocyte Lipid peroxidation and antioxidants in chronic alcoholics with alcoholic liver disease. Asian Journal of Pharmaceutical and Clinical Research. 2010; 3 (3): 183 – 185. 14. Carone D. Lipid peroxidation products and antioxidant enzymes in red blood cells during normal and diabetic pregnancy. Eur J Obstet Gynaecol Reprod Biol 1993;51:103–9. 15. Sherlocks S, Dooley SJ. In: Diseases of the liver and biliary system 10th Edition, London: Blackwell Science Ltd 1977; 371–384. 16. Tietz NW. In: Text book of clinical chemistry, Edited by NW Tietz, WB Saunders Company, Philadelphia, London, Toronto. 1986; 960–962. 17. Baker H, Frank D, Winley NC. Clinical Vitaminology 1968; 772. 18. Marklund S, Marklund G. Involvement of the superoxide anion radical in the autooxidation and a convenient assay for SOD. European Journal of Biochemistry. 1974; 47: 469 -74. 19. Beers, R.F. AND Sizer, I.W. A spectrophotometric method for measuring the breakdown of hydrogen peroxide by Catalase. J.Biol.Chem. 1952; 195, 133-140. 20. Paglia, D.E. AND Valentine, W N. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J.Lab.Clin.Med. 1967; 70, 158-159. 21. Pintu D. Masalkar and SubodhiniA. Abhang. Oxidative stress and antioxidant status in patients with alcoholic liver disease. Clinica chimica acta. May, 2005; 355 (1-2): 61 – 65. 22. Zhao M, Matter K, Laissure JA e al. Copper / zinc and manganese superoxide dismutase in alcoholic liver disease: immunohistochemical quantitation. Histol Histopathol. 1996; 11: 899 – 907. 23. De la Maza MP, Petermann M, Bunout D et al. Effect of long term vitamin E supplementation in alcoholic cirrhotics. J Am Coll Nurt. 1995; 14: 192 – 196. 24. Nordmann R, Ribiere C, Rouach H. Implication of free radical mechanisms in ethanol included cellular injury. Free Radical Biol Med. 1992; 12: 219 – 240. 25. Peters T J, Ward R J. Role of acetaldehyde in the pathogenesis of alcoholic liver disease. Mol. Aspects Med. 1998; 10: 179-190. 26. Suresh Chari and Madhur Gupta. Status of blood antioxidant enzymes in alcoholic cirrhosis. Indian Journal of Physiology and Pharmacology. 2003; 47 (3): 343 – 346. 27. Chandra R, Aneja R, Rewal C, Konduri R, Dass K, and Agarwal S. An opium alkaloid-papaverine ameliorates ethanol induced hepatotoxicity: diminution of oxidative stress. Ind. J. Clin. Biochem. 2000; 15(2): 155-60. 28. Mahadik SP, Soheffer, RE. Oxidative injury and potential use of antioxidants in schizophrenia. Prostaglandins Leukot Essent Fatty Acids 1996;55:45–54 [Review]. 29. Lenzi A, Cualosso F, Gandini L, Lombardo F and Dondero F. Placebo controlled double-blind cross over trial glutathione therapy, in male infertility. Hum. Reprod. 1993; 9: 2044. 30. Das KS, Balakrishnan V, Mukherjee S, Vasudevan DM.Evaluation of blood oxidative stress-related parameters in alcoholic liver disease and non-alcoholic fatty liver disease. Scand J Clin Lab Invest. 2008; 68(4): 323-34.

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com