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Abstract
There is a lot of evidence pertaining to the ethiopathogenetic importance of oxidative stress in a number of autoimmune diseases, including some immune-mediated neurological diseases such as multiple sclerosis. However, the role of oxidative stress and oxidative status in patients with myasthenia gravis is still an under-researched area. The aim of our research was to compare serum total and direct bilirubin, albumin, total proteins and creatinine levels in myasthenia gravis (MG) patients with healthy controls, and patients with multiple sclerosis (MS). The subjects were divided into three groups (92 MG patients, 68 healthy controls and 74 MS patients). All MG patients were newly diagnosed, classified with MGFA Clinical Classification, and divided into two groups regarding onset age (early < 50 years, late ≥50 years), sex (male, female), thymus pathology (present, absent). Serum antioxidant status was significantly lower in MG and MS group compared to the healthy controls (p < 0.05). There was no significant difference in serum antioxidant status between patients with MG and those with MS. Regarding MGFA Classification we have not found any correlation with serum levels of measured parameters. Our findings suggested that there was a potential role of oxidative process in MG pathology. Among the analyzed parameters, direct bilirubin showed significantly lower value in women, the elderly and in the group of MG patients with pathologically altered thymus gland.
Highlights
Oxidative stress (OS) is a disorder which appears as the result of prooxidant and antioxidant balance disturbance
The serum levels of total bilirubin, direct bilirubin, albumin, total proteins and creatinine were significantly lower in myasthenia gravis (MG) and multiple sclerosis (MS) group compared to the healthy control group (p < 0.05)
Regarding the age of onset, we found significantly lower values of creatinine in the early onset group (p < 0.05), and lower values of direct bilirubin, albumines and total proteins in patients with the late onset of disease (p < 0.05)
Summary
Oxidative stress (OS) is a disorder which appears as the result of prooxidant and antioxidant balance disturbance. When the free radical production overrides antioxidant capacity there is damage to cellular metabolism and cell structures (proteins, lipids, nucleic acids), which results in cell death by necrosis and apoptosis. Chronic acquired myasthenia gravis (MG) is an antigen-specific autoimmune disease of postsynaptic neuromuscular membrane, which is characterized by the impairment of neuromuscular transmission, usually mediated by antibodies against the nicotinic acetylcholine receptor [4]. Sporadic results suggested that excessive production of free radicals can cause the inactivation of nicotinic acetylcholine receptors and damage to the neuromuscular junction [5, 6]. There is evidence of oxidative stress in other neuromuscular disorders [7]
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