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      The effect of low dose ionizing radiation exposure on dynamic thiol-disulfide homeostasis and ischemia modified albumin levels: an observational study Translated title: Efeito da exposição à radiação ionizante de baixa dose na homeostase dinâmica de tiol-dissulfeto e níveis de albumina modificada por isquemia: estudo observacional

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          Abstract

          Background

          The primary objective of this study was to investigate the effect of low dose ionizing radiation exposure on thiol/disulfide homeostasis and ischemia modified albumin levels. The secondary objective is to compare thiol/disulfide homeostasis and ischemia modified albumin levels among the personnel exposed to low dose ionizing radiation in anesthesia application areas, in and out of the operation room.

          Methods

          The study included a total of 90 volunteers aged between 18 and 65 years old, with 45 personnel working in a setting with potential for radiation exposure (Exposed Group) and 45 personnel in a setting without radiation exposure (Control Group). Their native thiol, total thiol, disulphide, albumine and IMA levels were measured. Exposed group included personnel who were exposed to radiation outside the operating room – Operation room (−) Group and inside the operating room – Operation room (+) Group.

          Results

          Albumin, native and total thiol levels were significantly lower in the participants exposed to radiation in the anesthesia application area; no statistically significant difference was found in terms of disulfide and ischemia modified albumin levels. In the Operation room (−) Group exposed to radiation, native thiol and total thiol values were significantly lower compared to the Operation room (+) Group.

          Conclusion

          Awareness of being in danger of oxidative stress should be established in personnel exposed to radiation in the anesthesia application area following low dose ionizing radiation exposure, and the necessary measures should be taken.

          Resumo

          Justificativa

          O objetivo principal do estudo foi investigar o efeito de exposição à radiação ionizante de baixa dose nos níveis de homeostase tiol/dissulfeto e de albumina modificada por isquemia. O objetivo secundário foi comparar os níveis de homeostase tiol/dissulfeto e albumina modificada por isquemia entre indivíduos expostos à radiação ionizante de baixa dose nas áreas de procedimentos anestésicos, dentro e fora da sala de cirurgia.

          Método

          O estudo incluiu um total de 90 voluntários com idades entre 18 e 65 anos, 45 profissionais que trabalhavam em ambiente de exposição potencial a radiação (Grupo Exposto) e 45 profissionais que trabalhavam em ambiente sem exposição à radiação (Grupo Controle). Foram medidos os níveis de tiol nativo, tiol total, dissulfeto, albumina e albumina modificada por isquemia. O Grupo Exposto era constituído por profissionais expostos a radiação fora da sala de cirurgia – Grupo sala de cirurgia (−) e dentro da sala de cirurgia – Grupo sala de cirurgia (+).

          Resultados

          Os níveis de albumina, tiol nativo e total foram significantemente mais baixos nos participantes expostos à radiação em área de realização de anestesia, e nenhuma diferença estatisticamente significante foi encontrada para os níveis de dissulfeto e albumina modificada por isquemia. No Grupo sala de cirurgia (−), os valores de tiol nativo e tiol total foram significantemente mais baixos quando comparados ao Grupo sala de cirurgia (+).

          Conclusões

          Os profissionais expostos à radiação em área de realização de anestesia devem ser conscientizados quanto ao perigo do estresse oxidativo após exposição à radiação ionizante de baixa dose e medidas cabíveis devem ser instituídas.

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          Most cited references26

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          A novel and automated assay for thiol/disulphide homeostasis.

          To develop a novel and automated assay determining plasma thiol/disulphide homeostasis, which consists of thiol-disulphide exchanges.
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            A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report.

            We initially observed a phenomenon of reduced in vitro binding of exogenous cobalt [Co(II)] to the N-terminus of human serum albumin (HSA) in emergency chest pain patients with early onset unstable angina and myocardial infarction. We then developed a colorimetric assay to measure cobalt-HSA binding and record the results in absorbance units (ABSU). In a preliminary clinical study of 139 emergency patients with acute chest pain, 99 patients with evidence of myocardial ischemia (Group 1) had elevated assay levels (mean ABSU +/- SD; 0.519 +/- 0.086) compared to 40 patients (Group 2) with no evidence of ischemia (0.316 +/- 0.092) (p < 0.00001). In Group 1, 95 of 99 (96.0%) patients had levels higher than a decision threshold of 0.400 ABSU and in Group 2, 37 of 40 (92.5%) samples had higher cobalt binding capacity (ABSU
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              Specific antioxidant properties of human serum albumin

              Human serum albumin (HSA) has been used for a long time as a resuscitation fluid in critically ill patients. It is known to exert several important physiological and pharmacological functions. Among them, the antioxidant properties seem to be of paramount importance as they may be implied in the potential beneficial effects that have been observed in the critical care and hepatological settings. The specific antioxidant functions of the protein are closely related to its structure. Indeed, they are due to its multiple ligand-binding capacities and free radical-trapping properties. The HSA molecule can undergo various structural changes modifying its conformation and hence its binding properties and redox state. Such chemical modifications can occur during bioprocesses and storage conditions of the commercial HSA solutions, resulting in heterogeneous solutions for infusion. In this review, we explore the mechanisms that are responsible for the specific antioxidant properties of HSA in its native form, chemically modified forms, and commercial formulations. To conclude, we discuss the implication of this recent literature for future clinical trials using albumin as a drug and for elucidating the effects of HSA infusion in critically ill patients.
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                Author and article information

                Contributors
                Journal
                Braz J Anesthesiol
                Braz J Anesthesiol
                Brazilian Journal of Anesthesiology
                Elsevier
                0104-0014
                2352-2291
                11 May 2020
                May-Jun 2020
                11 May 2020
                : 70
                : 3
                : 233-239
                Affiliations
                [a ]University of Necmettin Erbakan, Medical Faculty, Department of Anaesthesiology, Konya, Turkey
                [b ]University of Necmettin Erbakan, Medical Faculty, Department of Gastroenterology, Konya, Turkey
                [c ]University of Necmettin Erbakan, Medical Faculty, Department of Radiology, Konya, Turkey
                [d ]University of Yildirim Beyazit, Medical Faculty, Department of Medical Biochemistry, Ankara, Turkey
                Author notes
                [* ]Corresponding author. drsulearican@ 123456hotmail.com
                Article
                S0104-0014(20)30067-1
                10.1016/j.bjane.2020.04.023
                9373708
                32482354
                8365ca2e-7487-432c-84f8-ca616f7025a9
                © 2020 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 11 September 2019
                : 21 February 2020
                Categories
                Clinical Research

                anesthesia,ischemia modified albumin,radiation,thiol,anestesia,albumina modificada por isquemia,radiação,tiol

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