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On Aug 2018




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Consultant
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Aug 2018




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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.
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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
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On Jan 2020

Important Notice

Original article / research
Year : 2011 | Month : April | Volume : 5 | Issue : 2 | Page : 249 - 251 Full Version

The Role Of Oxidative Stress And The Effect Of Radiotherapy On The Plasma Oxidant-Antioxidant Status In Head And Neck Cancer


Published: April 1, 2011 | DOI: https://doi.org/10.7860/JCDR/2011/.1240
MALATHI M, VIJAY M, SHIVASHANKARA A R

Dept of Biochemistry, Father Muller Medical College and Hospital, Mangalore-575002; Karnataka, India.

Correspondence Address :
Dr. Malathi M., Professor of Biochemistry, Father Muller Medical
College and Hospital, Mangalore-575002; Karnataka, India.
E-mail : malathi.mala@hotmail.com
Phone : 0824 2238255, 9480229866.

Abstract

Objectives: The present study was aimed to assess the oxidantantioxidant status in head and neck cancer patients before and after radiotherapy.

Methods: The subjects comprised of patients who had visited the Oncology Department and were diagnosed of head and neck cancer. The plasma levels of malondialdehyde (MDA), the marker of lipid peroxidation, and the antioxidants, superoxide dismutase (SOD), vitamin A, vitamin C and ceruloplasmin, were assayed before and after radiotherapy, in comparison to the healthy controls.

Results: The plasma levels of MDA were higher and the levels of SOD, vitamin A, vitamin C and ceruloplasmin were lower inthe head and neck cancer patients as compared to those in the healthy controls. These parameters showed significant changes after radiotherapy, as indicated by a lower level of MDA and higher levels of SOD, vitamin A, vitamin C and ceruloplasmin in the plasma of the cancer patients after radiotherapy, as compared to the plasma levels before radiotherapy. All the results were statistically significant (P < 0.001).

Conclusions: Radiotherapy caused a reduction in the lipid peroxidation and an improvement in the antioxidant status of the head and neck cancer patients.

Keywords

Antioxidants, Head and Neck Cancer, Lipid Peroxidation, Oxidative Stress

Cancer is the second leading cause of death worldwide. Eleven million new cases of cancer are diagnosed every year (1). It is estimated that there are approximately 2-2.5 million cases of cancer in India at any given point of time, with around 700,000 new cases being detected every year (2). Cancers of the head and neck include cancers of the buccal cavity, the head and neck subset, the larynx, pharynx, thyroid, the salivary glands, and the nose/nasal passages. Head and neck cancers account for approximately 6 percent of all the malignancies in the United States, and over one third of all the cancers in India (3), (4). It is the sixth common cause of death in males and the seventh in females (3). India also has the dubious distinction of having the world’s highest reported incidence of head and neck neoplasia in women. The disproportionately higher prevalence of head and neck cancers with respect to other malignancies in India may be due to the use of tobacco in various forms, the consumption of alcohol and a low socioeconomic condition which is related to poor hygiene, a poor diet or infections of viral origin (4).

Free radicals are implicated in the pathogenesis of a multistage process of carcinogenesis. They are proposed to cause DNA base alterations, strand breaks, damage to the tumour suppressor genes and an enhanced expression of the proto-oncogenes [5 -8]. The burst of the reactive oxygen species (ROS) and the reactive nitrogen species (RNS) has been implicated in the development of cancer. Increased levels of lipid hydroperoxide, MDA and nitric oxide and decreased levels of the antioxidants, catalase, SOD, glutathione peroxidase, vitamin C and vitamin E, in blood and tissues, have been reported in head and neck cancer patients (9)(10)(11)(12)(13)(14)(15)
Radiotherapy is a cornerstone in the treatment of head and neck cancer. Ionic irradiation exposes all cells in the involved field to highlevels of oxidative stress, thus resulting in the formation of ROS, increasing DNA damage and ultimately leading to cell death (16). Another mechanism of the action of radiotherapy is to alter cellular homeostasis, thus modifying the signal transduction pathways and predisposing to apoptosis (16). However, there are conflicting reports on the effect of radiotherapy on oxidative stress. Some studies have reported increased oxidative stress after radiotherapy (17), (18) while others have reported decreased oxidative stress after radiotherapy in cancer patients (18), (19), (20). These studies have shown varied responses of the individual antioxidants to radiotherapy.

The present study was taken up with a view of the paucity of Indian studies on the effects of radiotherapy on the oxidant-antioxidant status in cancer and the existing lacunae in the field of oxidative stress biomarkers of cancer. We assessed MDA, the marker of lipid peroxidation, and the antioxidants, SOD, vitamin A, vitamin C and ceruloplasmin, in the blood of head and neck cancer patients, before and after radiotherapy.

Material and Methods

Source of Data: The study was carried out at the Father Muller Medical College and Hospital, Mangalore. The study protocol was approved by the Institutional Ethics Committee. The subjects comprised of fifty patients who had visited the Oncology Department and were diagnosed of head and neck cancer, based on clinical examination and histopathological studies; they ranged in ages from 30 to 80 years (Group-1A). The same patients were then followed up after they underwent a radiotherapy regimen for six weeks (Group-1B). Fifty, age- and sex-matched, apparently healthy volunteers were included as controls in the study (Group-2). Patients with cancer in regions other than the head and neck, anysystemic diseases and infections, and alcoholics, smokers and tobacco chewers without diagnosed cancer, were excluded from the study. A detailed history of the habits (smoking, alcohol abuse and tobacco chewing), chronic illness and clinical history, was collected from the subjects. Informed consent was obtained from all the participants.

Assays: Six ml. of blood was collected in an EDTA tube by taking aseptic precautions, and this was centrifuged at 3000 rpm to separate the cells and plasma. The plasma was analyzed for the levels of MDA, vitamin A, vitamin C and ceruloplasmin, and the activity of SOD. MDA, the sensitive and convenient marker of lipid peroxidation, was estimated as thiobarbituric acid-reactive substances (21). The plasma levels of vitamin A (retinol) were assayed after extraction into heptane and by then measuring the absorbance at 327 nm (22). The measurement of vitamin C (ascorbic acid) was based on the oxidation of ascorbic acid to dehydroascorbic acid, which on treating with 2,4 dinitrophenyl hydrazine in an acidic medium, formed a red coloured bishydrazone (23). The ceruloplasmin levels were estimated, based on the oxidation of p-phenylene diamine, the colour intensity of which was measured at 530 nm (24). SOD was estimated as super oxide anions are involved in the auto oxidation of pyrogallol at an alkaline pH of 8.5. SOD inhibits the auto oxidation of pyrogallol, which can be determined as an increase in its absorbance at 420nm (25).

Statistical Analysis: The results were evaluated by employing the unpaired “t” test, the paired “t” test and the Chi- square test.

Results

In a total of fifty patients with head and neck cancer, the major anatomical sites of the carcinoma were the tongue (n=13), the oropharynx (n=6) and the hypopharynx (n=4). The remaining sites with a lesser incidence were the buccal mucosa (n=3), the mandible (n=3), the cheek (n=3), the nasopharynx (n=3), the pyriform fossa (n=3), the maxilla (n=3) the vocalcord (n=3), and one each in the floor of the mouth, the supraglotis, the pharynx, the post cricoids, the retromandibular trigone and the right maxillary antrum. The results of the present study are presented in (Table/Fig 1).

* One unit of SOD is defined as the amount of enzyme required to cause 50% inhibition of pyrogallol auto-oxidation. ** Significance of difference of the value when compared to controls, P < 0.001 (Highly significant) *** Significance of difference of the value when compared to before radiotherapy, P < 0.001 (Highly significant)The plasma levels of malondialdehyde were higher and the levels of superoxide dismutase, vitamin A, vitamin C and ceruloplasmin were lower in the head and neck cancer patients (Group-1A.), as compared to those in the controls (Group-2). These parameters showed significant changes after radiotherapy, as indicated by lower levels of MDA and higher levels of SOD, vitamin A, vitamin C and ceruloplasmin in the plasma of cancer patients after radiotherapy (Group-1B), as compared to the plasma levels before radiotherapy (Group-1A). All the results were statistically significant (P < 0.001).

Discussion

The present study revealed increased lipid peroxidation and lowered levels of antioxidants in the head and neck cancer patients. The levels of MDA, the marker of lipid peroxidation, were higher almost by 4-fold in the cancer patients as compared to the controls. The levels of the antioxidants, SOD, vitamin C, vitamin A and ceruloplasmin, were decreased in the head and neck cancer patients. This suggests an increased oxidative stress being involved in the pathogenesis of head and neck cancer.

Previous studies have reported increased blood levels of lipid peroxides and MDA, and decreased blood levels of antioxidants in head and neck cancers [8-15]. Red blood cell membranes are more prone to lipid peroxidation because of their high polyunsaturated fatty acid content and their direct exposure to molecular oxygen and haemoglobin. The compensatory mechanism to counter the ROS results in reduced levels or activities of enzymatic and non-enzymatic antioxidants in blood.

Radiotherapy is the major form of treatment which is available for head and neck cancer. Studies have shown varied findings with respect to the effect of radiotherapy on the oxidant-antioxidant status. Some authors have observed increased oxidative stress after radiotherapy and have suggested that radiation-induced free radicals cause oxidative damage to biomolecules (17), (18), (26). The authors advocating increased oxidative stress in radiotherapy have shown from their studies, that supplementation with antioxidants such as alpha-tocopherol ameliorates the oxidative damage caused by radiotherapy (26). Chitra and Shyamaladevi (26) observed a significant decrease in the malondialdehyde levels and an increase in the activities of antioxidant enzymes in oral cancer patients who were supplemented with alpha-tocopherol during radiotherapy, as compared to radiation-treated oral cancer patients without alpha-tocopherol supplementation.

Studies have shown decreased lipid peroxidation and increased activities of antioxidants after radiotherapy (18), (19), (20). The findings from our study also suggest the amelioration of oxidative stress by radiotherapy, as indicated by decreased MDA levels, and increased levels of SOD, vitamin C, vitamin A and ceruloplasmin in head and neck cancer patients after radiotherapy. Kasapovic et al. (18) proposed that the response to radiotherapy involves the age-related impairment of the antioxidant capacity for the elimination of free radicals, thus causing oxidative damage to the blood cells. They suggested that the cytotoxic effects of radiation on the healthy tissues might be more pronounced during the aging process. In concordance with our study, some researchers have observed increased blood levels of SOD, catalase, glutathione reductase, ceruloplasmin and glutathione in post-radiotherapy cancer patients (18), (19), (20).

Conclusion

The involvement of oxidative stress in head and neck cancer is evident from increased lipid peroxidation and decreased levels of antioxidants in plasma. Radiotherapy caused a reduction in lipid peroxidation and an improvement in the antioxidant status of head and neck cancer patients. Though the levels of antioxidants in plasma did not reach the control values in the post-radiotherapy scenario in cancer patients, the improvement in the antioxidant capacity was of vital importance for survival and for an improved quality of life ofthe radiation-treated patients. Further studies with a larger sample size, different stages of head and neck cancer and assessment of the effect of antioxidant supplementation before and during the radiotherapy regimen, are needed.

Acknowledgement

The authors are indebted to the Director, the Administrators and the Dean and the Chief of the Medical Services, Father Muller Medical College and Hospital, Mangalore, for their support and encouragement and for providing the required infrastructure

References

1.
Park K. Park’s Text Book of Preventive and Social Medicine, 19th edition, M/s B. Bhanot; 2007: 313 – 15.
2.
National Cancer Registry Programme. Annual Report. ICMR; 2005;776.
3.
Bhattacharjee A, Chakraborty A, Purkaystha P . Prevalence of head and neck cancers in the North East -an institutional study. Indian J Otolaryngol Head Neck Surg 2006; 58 :15-19.
4.
Mehrotra R, Singh M, Gupta RK, Singh M, Kapoor AK. Trends of prevalence and pathological spectrum of head and neck cancers in North India. Indian J Cancer 2005;42:89-93
5.
Cerutti PA. Oxy-radicals and cancer. Lancet 1994; 344: 862-63.
6.
Gonalez RA. Free radicals, oxidative stress and DNA metabolism in human cancer. Cancer Invest 1999; 17: 376-77.
7.
Irshad M, Chaudhuri PS. Oxidants, antioxidants and carcinogenesis. Indian J Exp Biol 2002; 40: 1213-32.
8.
Patel BP, Rawal UM, Raval RM, Shukla SN, Patel PS. Tobacco, antioxidant enzymes, oxidative stress and genetic susceptibility in oral cancer. Am J Clin Oncol 2008; 31 : 454-59.
9.
Halliwell B. Oxidative stress and cancer: have we moved forward? Biochem J. 2007;401:1–11
10.
Rasheed MH, Beevi SS, Armugam G, Brennan PA. Enhanced lipid peroxidation and nitric oxide products with deranged antioxidant status in patients with head and neck squamous cell carcinoma. Oral Oncology 2007; 43:333-38.
11.
Sultan Beevi S S , Hassannal Rasheed AM, Geetha A. Evaluation of oxidative stress and nitric oxide levels in patients with oral cavity cancer. Jap J Clin Oncol 2004; 34 : 379-85.
12.
Manoharan S, Kolanjappan K, Suresh K, Panjamurthy K. Lipid peroxidation and antioxidant status in patients with oral squamous cell carcinoma. Indian J Med Res 2005; 122 : 529-34.
13.
Stich HF, Anders F. The involvement of reactive oxygen species in oral cancer of betelquid-tobacco chewers. Mutation Res 1989; 214 : 47-61.
14.
Nisha, Sachdeva A, Lal H. Some oxidative stress related parameters in patients with head and neck carcinoma. Indian J Clin Biochem 2008; 23:38-40.
15.
Khanna R, Thapa PB, Khanna HD, Khanna S, Khanna AK, Shukla HS. Lipid peroxidation and antioxidant enzyme status in oral carcinoma patients. Kathmandu University Medical Journal 2005; 3: 334-39.
16.
Sakhi AK, Russnes KM, Thoresen M, Bastani NE, Karlsen A, Smeland S, Blomhoff R. Pre-radiotherapy plasma carotenoids and markers of oxidative stress are associated with survival in head and neck squamous cell carcinoma patients: a prospective study. BMC Cancer 2009;9:458-62.
17.
Sabitha KE, Shyamaladevi CS. Oxidant and antioxidant activity changes in patients with oral cancer and treated with radiotherapy. Oral Oncol 1999; 35: 272-77.
18.
Kasapovic J, Pejic S, Todorovic A, Stojilkovic V, Radosevic-Jelic L, Pajovic. Antioxidant status in breast cancer patients of different ages after radiotherapy. Arch Biol Sci Belgrade 2009; 61: 23-8.
19.
Gupta A, Bhatt MLB, Misra MK. Assessment of free radical-mediated damage in head and neck squamous cell carcinoma patients and after treatment with radiotherapy. Indian J Biochem Biophys 2010; 47: 96-99.
20.
Cartmel B, Bowen D, Ross D, Johnson E, Mayne ST. A randomized trial of an intervention to increase fruit and vegetable intake in curatively treated patients with early-stage of head and neck cancer. Cancer Epidemiol Biomarkers Prev 2005; 14: 2848-54.
21.
Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem. 1979; 95:351-58.
22.
Bessey OA, Lowry OH, Brock MJ, Lopez JA. The determination of vitamin A and carotene in small quantities of blood serum. J Biochem 1946:166-77.
23.
Omaye ST, Turnbull JD, Sauberlieh HE. Selected methods for the determination of ascorbic acid in animal cells, tissues and fluids. In Methods Enzymol 1979;62: 3-8.
24.
Sundrman FW, Nomoto S. Measurement of human serum ceruloplasmin by its p-phenylenediamine oxidase activity. Clinical Chemistry 1970; 16: 903-9.
25.
Nandi A, Chatterjee IB. Assay of superoxide dismutase in animal tissues. J Biosci 1988; 13: 305-15.
26.
Chitra S, Shyamaladevi CS. Effect of α-tocopherol on pro-oxidant and antioxidant enzyme status in radiation-treated oral squamous cell carcinoma. Indian J Med Sci 2008; 62: 141-148.

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