Investigation of Oxidative Stress and Antioxidant Pathways in Nasal Polyp Tissue: Peroxynitrite and Malondialdehyde Compared to NF-E2-related factor 2, Kelch-like ECH-associated protein one and Glycogen Synthase Kinase-3ß

Abstract

Objective: Nasal polyps are benign mucosal lesions with multifactorial causes that grow into the nasal cavity and are associated with inflammation. This study aims to investigate whether Nrf2, Keap1, GSK-3ß, Peroxynitrite, and malondialdehyde may be used as biochemical markers to determine the relationship between oxidative stress and nasal polyps. The goal is to explore the etiology of nasal polyps and contribute to the literature for a better understanding of the inflammatory pathophysiology of nasal polyps, ultimately leading to the development of new therapeutic approaches. Materials and Methods: A total of 94 patients aged between 12 and 65 years who underwent a surgical operation for polyps (n = 49, case group) and septoplasty (n=45, controls) between February and September 2022 at the Department of Otorhinolaryngology, Faculty of Medicine, Gaziantep University were included in the study. Tissues taken from the polyp and the inferior turbinate in the case and control groups, respectively, were homogenized at the biochemistry laboratory and investigated using the ELISA method to compare the Nrf-2, Keap1, GSK-3ß, malondialdehyde, and peroxynitrite levels. Results: Consistent with the study hypothesis, Nrf2 levels were lower, and Keap1 levels were higher in the case group, although the difference was not statistically significant. Although studies have reported increased levels of GSK-3β in chronic rhinosinusitis, they were statistically lower in polyps. This may be associated with the complexity of the GSK-3β network or the adequacy of Keap1 alone for Nrf2 inhibition. Peroxynitrite and malondialdehyde (MDA) levels are indicators of oxidative stress. Conclusion: Nrf2, Keap1, GSK-3ß, MDA, and Peroxynitritetrite may be involved in the aetiology of nasal polyps based on the study's results. Keap1 and GSK-3ß, Nrf2 and Nrf2 module, actors which regulate oxidative stress, played a role in the pathophysiology of nasal polyps in combination with Peroxynitritetrite and malondialdehyde, according to the study findings. Potential treatments for nasal polyps are better understood through more extensive and well-matched studies.