ERYTHROCYTE GLUTATIONE AND PARAMETERS OF OXIDATIVE STRESSAND INFLAMMATION IN ACUTE CORONARY SYNDROME

Objective. To study erythrocyte glutathione system, its reduction potential compared to oxidative stress indicators and systemic inlammation in patients with acute coronary syndrome (ACS).

Design and methods. Based on the concept of prooxidant and antioxidant redox signaling erythron functions, parameters of oxidative stress, inlammation, metabolism and redox erythrocyte glutathione status in 47 patients with myocardial infarction with ST segment elevation (STEMI) on the electrocardiogram and 71 patients with unstable angina (UA) were studied and compared.

Results. A severe disruption of prooxidant-antioxidant balance and systemic inlammatory response in patients with UA with a decrease in superoxide dismutase activity in both groups of patients was established. The opposite changes in the concentrations of total glutathione and reduced glutathione in erythrocytes were obtained: an increase in STEMI and reduction in UA together with the low glutathione reductase activity in the first case. A signiicant shift of erythrocytes redox potential in the oxidized side on 15,4 mV in patients with UA and higher glutathione peroxidase activity were revealed.

Conclusions. Against the background of pronounced impairments in a prooxidant-antioxidant balance and manifestations of a systemic inlammatory response, patients with UA (in contrast to patients with STEMI) showed decreased concentrations of total and reduced glutathione and the ratio of reduced to oxidized glutathione. This causes a shift in the erythrocyte glutathione redox potential to the oxidized side and an increase in the activity of glutathione peroxidase, the key prognostic factor in ACS. The changes in the erythrocyte glutathione system in ACS relect the processes of erythron adaptation in maintaining systemic redox signaling, due to protein deglutathionylation, and preventing further hemorheologic complications.

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