Thiol/disulfide homeostasis as a novel indicator of oxidative stress during the treatment process of patients with septic arthritis

OBJECTIVES: This study aims to investigate dynamic thiol/disulfide homeostasis as a novel indicator of oxidative stress and to find out its association with standard inflammatory markers during the treatment of patients with septic arthritis (SA). PATIENTS AND METHODS: In this prospective study, a new colorimetric method for measuring thiol/disulfide homeostasis was assessed between May 2013 and October 2014 in 24 patients with SA (14 males, 10 females; mean age 14.5±19.1 years; range, 1 to 80 years) at baseline and the end of the third week of the treatment, and in 24 healthy controls (14 males, 10 females; mean age 12.5±18.7 years; range, 1 to 85 years). Also, standard inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate, and white blood cell count were evaluated. RESULTS: At baseline, serum disulfide was higher in SA group compared to the control group, whereas native thiol was lower (p<0.05 for all). At the end of the third week of the treatment, serum disulfide level was lower, whereas the native thiol was higher compared to baseline (p<0.05 for all). In addition, serum disulfide level was positively correlated with CRP (r=0.736, p<0.001) and disulfide/native thiol ratio (r=0.779, p<0.001). Furthermore, in multiple regression analyses, the disulfide level was independently associated with CRP (β=0.226, p=0.005). CONCLUSION: Our results suggest that the elevated levels of serum disulfide and standard inflammatory markers at baseline in patients with SA and decreased levels of these parameters are related with oxidative stress. This homeostasis shifted towards disulfide formation due to thiol oxidation. Therefore, thiol/ disulfide homeostasis may be a helpful biomarker for the follow- up in patients with SA.