Abstract
SummaryBackgroundThe inappropriate elevation of parathormone (PTH), which regulates the process of angiogenesis in parathyroid tissue, causes the changes of activity of enzymes responsible for the removal of free radicals. Parathyroidectomy (PTX) in patients with primary hyperparathyroidism (PHPT) lowers the level of PTH and leads to the reduction of risk of cardiovascular and all-cause mortality by normalization of the antioxidant status. Therefore, the aims of the study were to assess the activity of antioxidant enzymes and free radical reaction products in patients after parathyroidectomy, and to evaluate the correlation between the systemic oxidative stress and angiogenic parameters.Materials and methodsPatients with PHPT treated surgically were enrolled into the study. Total antioxidant capacity (TAC), total oxidative status (TOS), oxidative stress index (OSI), superoxide dismutase (SOD), ceruloplasmin (CER), lipid hydroperoxides (LHP) and malondialdehyde (MDA) were measured before and after parathyroidectomy. The immunohistological expression of angiogenic factors in parathyroid specimens was assessed by the BrightVision method from ImmunoLogic using murine monoclonal anti-human: anti-VEGF, anti-CD31 and anti-CD106 antibodies.ResultsThe significant increase of TAC, CER, reduction of TOS, MDA, SOD, especially for cytoplasmic form, and significant decrease of OSI, LHP were observed after PTX. There was no significant correlation between changes of oxidative stress markers and angiogenic parameters: VEGF, CD-31, CD-106 in parathyroid tissue. The correlation level was low and medium.ConclusionsParathyroidectomy causes down-regulation of lipid peroxidation processes and leads to reduction of oxidative stress in patients with PHPT. The decrease in the OSI is the results of down-regulation of oxidative stress in the postoperative period. The change of the antioxidant status has no impact on angiogenesis processes in parathyroid tissue.
Highlights
Primary hyperparathyroidism (PHPT) is caused by an inappropriate elevation of parathormone (PTH) level by one or more glands, which usually results in hypercalcemia [1]
Endothelium is responsible for vascular tone, mainly due to the production of nitrogen monoxide (NO), which has been implicated in maintaining the balance between vasoconstriction and vasodilation
Parathyroidectomy in patients with primary hyperparathyroidism (PHPT) resulted in the significant increase of total antioxidant capacity (TAC) (p < 0.001) and substantial reduction of total oxidative status (TOS) (p = 0.027)
Summary
Primary hyperparathyroidism (PHPT) is caused by an inappropriate elevation of parathormone (PTH) level by one or more glands, which usually results in hypercalcemia [1]. Due to the results of studies revealing the impact of PHPT on the increase of the incidence of cardiovascular diseases, and prob-. Patients with primary hyperparathyroidism have increased risk of cardiovascular disease, which may be caused by a great number of factors, such as hypercalcemia [6], low vitamin D level [7], osteoporosis [8], or hyperphosphatemia [9]. Vascular endothelial cells in diseases, including hypertension, hypercholesterolemia, and diabetes, produce increased amounts of reactive oxygen species (ROS), which cause formation of peroxynitrites and neutralize NO activity. This leads to atherotrombosis and atherosclerosis [12]. Several reports suggested the possibility that parathyroidectomy could reduce the risk of cardiovascular complications [3]
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