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Background: Free radicals have been proposed to be responsible from the pathogenesis of many diseases because of their harmful effects on the cells and tissues. There are some defence mechanisms in the organism to avoid the harmful effects of free radicals. The enzymes responsible from antioxidant defense have trace elements like selenium, zinc and copper within their structure. Decreased levels of these elements lead to a reduction in antioxidant activity. This study was conducted to determine serum levels of some trace elements (Se, Zn, Cu) in asthmatic patients during acute attacks, after inhaled corticosteroid therapy and during asymptomatic periods in order to evaluate the relation of these elements to different clinical phases of asthma.
Medhods :The study and control cases included 40 asthmatic children being followed up in Department of Pediatric Allergy Dokuz Eylül Universty Medical Faculty, and 19 children presenting with enuresis noctuma and having no personal or family history of allergy. Patients presenting with acute asthmatic attacks (study group 1, n=22) were evaluated before the treatment (pretreatment) and after three months of Fluticasone Propionate (400 mg daily) therapy (posttreatment).The other study group included asthmatic patients who were asymptomatic (study group 2, n=18). Control group was the children presenting with enuresis with (group 3, n= 19). Serum selenium, zinc and copper levels were measured in all cases. In addition, pulmonary function tests were performed and FVC and FEV1 were determined in all of the children.
Results: Serum selenium and zinc levels during acute attacks and after inhaled corticosteroid therapy were significantly different in groupl, being lower during acute attacks (p<0.05). However, pre and posttreatment serum copper levels did not differ (p>0.05). FVC and FEV1 were also statistically different in the pre and posttreatment periods (p<0.05). Although serum selenium and zinc levels were significantly lower when group 1 (pretreatment) was compared with groups 2 and 3 (p<0.05), serum copper levels did not differ between the groups (p>0.05). FVC and FEV1 were also significantly different between the three groups (p<0.05).
Conclusion: These results show that, there is an oxidant stress in bronchial asthma, and antioxidant capacity decreases in parallel to a decrease in serum selenium and zinc levels. This leads to a further increase in oxidant stress, and as a result, inflammation and hyperreactivity in the airways becomes more evident.We speculate that, dietary deficiencies in selenium and zinc should be avoided with proper supplementations in the management of airway inflammation due to free oxygen radicals in asthmatic patients to increase the effect of antioxidant defense system.