Oxidative stress, hemoglobin content, superoxide dismutase and catalase activity influenced by sulphur baths and mud packs in patients with osteoarthritis

Abstract

Background/Aim. It is weel-known that sulphur baths and mud paks demonstrate beneficial effects on patients suffering from degenerative knee and hip osteoarthritis (OA) through the increased activity of protective antioxidant enzymes. The aim of this study was to assess lipid peroxidation level, i.e. malondialdehyde concetration, in individuals with knee and/or hip osteoarthritis (OA), as well as to determine the influence of sulphur baths and mud packs application on the activity of superoxide dismutase (SOD) and catalase (CAT) in order to minimize or eliminate excessive free radical species production (oxidative stress). Methods. Thirty one patiens with knee and/or hip OA of both sexes were included in the study. All OA patients received mud pack and sulphur bath for 20 minutes a day, for 6 consecutive days a week, over 3 weeks. Blood lipid peroxidation, ie malondialdehyde concentration, superoxide dismutase and catalase activity were measured spectrophotometrically, before, on day 5 during the treatment and at the end of spa cure. Healthy volunteers (n = 31) were the controls. Results. The sulphur baths and mud packs treatment of OA patients caused a significant decrease in plasma malondialdehyde concentration compared to the controls ( p < 0.001). The mean SOD activity before the terapy was 1 836.24 U/gHb, on day 5 it rose to 1 942.15 U/gHb and after the spa cure dropped to 1 745.98 U/gHb. Catalase activity before the therapy was 20.56 kU/gHb and at the end of the terapy decreased to 16.16 kU/gHb. The difference in catalase activity before and after the therapy was significant (p < 0.001), and also significant as compared to control (p < 0.001). At the end of the treatment significant increase of hemoglobin level and significant decrease of pain intensity were noticed. Conclusion. A combined 3-week treatment by sulphur bath and mud packs led to a significant decrease of lipid peroxidation in plasma, as well as pain intensity in the patients with OA. These changes were associated with changes in plasma activity of SOD and CAT and a significant increase of hemoglobin level suggesting their role in beneficial effect of spa therapy in the patients with OA.Uvod/Cilj. Poznato je da sumporne kupke i pakovanja blata imaju povoljno delovanje kod bolesnika sa osteoartritisom (OA) kolena i kuka zahvaljujuci povisenoj aktivnosti antioksidantnih zastitnih enzima. Cilj ove studije bio je pracenje nivoa lipidne peroksidacije, tj. koncentracije malondialdehida, kod bolesnika sa osteoartritisom (OA) kolena i/ili kuka, kao i utvrdjivanje uticaja sumporne kupke i blatnog pakovanja na aktivnost superoksid-dismutaze (SOD) i katalaze (CAT) sa ciljem da ublaze ili eliminise oksidativni stres. Metode. Bolesnici sa OA kolena i/ili kuka oba pola (n = 31) bili su ukljuceni u studiju. Svi bolesnici dobijali su blatna pakovanja i sumporne kupke 20 minuta dnevno, sest dana u nedelji, ukupno tri nedelje. Nivo lipidne peroksidacije u krvi, tj. koncentracija malondialdehida, aktivnost superoksid-dismutaze i katalaze mereni su spektrofotometrijski, pre tretmana, petog dana lecenja i na kraju tretmana. Kontrolnu grupu cinile su 33 zdrave osoba. Rezultati. Tretman blatnim pakovanjima i sumpornim kupkama kod bolesnika sa OA izazvao je znacajno snizenje koncentracije malondialdehida u plazmi u poredjenju sa kontrolnom grupom (p < 0,001). Prosecna vrednost aktivnosti SOD bila je 1 836,24 IJ/gHb pre pocetka tretmana, 5. dana porasla je na 1 942,15 IJ/gHb i nakon spa tretmana opala na 1 745,98 IJ/gHb. Aktivnost katalaze pre terapija bila je 20,56 kIJ/gHb, a na kraju tretmana 16,16 kIJ/gHb. Razlika u aktivnosti katalaze pre i posle terapije bila je znacajna (p < 0,001), a takodje je znacajna i u poredjenju sa kontrolnom grupom (p < 0,001). Na kraju lecenja doslo je do znacajnog porasta nivoa hemoglobina i znacajnog smanjenja bola i povecanje obima pokreta u zahvacenom zglobu. Zakljucak. Sumporne kupke u kombinaciji sa pakovanjima blata tokom tronedeljnog tretmana dovele su do znacajnog smanjenja stepena lipidne peroksidacije u plazmi i smanjenja intenziteta bola kod obolelih od OA. Ovo je bilo praceno promenama u aktivnosti antioksidantnih enzima, SOD i CAT i porastom nivoa hemoglobina, sto ukazuje na njihovu ulogu u postignutom terapijskom efektu banjskg treatmana.