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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10208-10214
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10208
Effect of tumor necrosis factor-α antagonists on oxidative stress in patients with Crohn’s disease
Kazunari Yamamoto, Toshimi Chiba, Takayuki Matsumoto
Kazunari Yamamoto, Toshimi Chiba, Takayuki Matsumoto, Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka City, Iwate 020-8505, Japan
Author contributions: Yamamoto K, Chiba T and Matsumoto T contributed equally to this work; Yamamoto K, Chiba T and Matsumoto T designed the research; Yamamoto K performed the research; Yamamoto K contributed new reagents/analytic tools; Yamamoto K analyzed the data; Yamamoto K, Chiba T and Matsumoto T wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Human Ethics Review Committee of Iwate Medical University (No.H24-62).
Informed consent statement: All study participants provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kazunari Yamamoto, MD, Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka City, Iwate 020-8505, Japan. m77_ky@yahoo.co.jp
Telephone: +81-19-6515111 Fax: +81-19-6526664
Received: March 25, 2015
Peer-review started: March 27, 2015
First decision: May 18, 2015
Revised: June 1, 2015
Accepted: July 15, 2015
Article in press: July 15, 2015
Published online: September 21, 2015
Processing time: 177 Days and 17.8 Hours
Abstract

AIM: To investigate changes in oxidative stress in Crohn’s disease (CD) before and after anti-tumor necrosis factor (TNF)-α treatment.

METHODS: A total of 42 patients with active CD, who were scheduled to be treated by anti-TNF-α antibodies, were enrolled. Serum levels of diacron-reactive oxygen metabolites (d-ROM), biological antioxidant potential (BAP), and modified ratio of oxidative stress and antioxidant capacity (m-OA) were measured using the Free Radical Analytical System before and 8 wk after induction of therapy with infliximab or adalimumab. The values for oxidative stress were correlated with disease activity and clinical response as determined by the CD activity index (CDAI) at 8 and 54 wk after the therapy.

RESULTS: Prior to treatment, d-ROM showed significant correlations with CDAI (r = 0.42, P < 0.01). There was a significant negative correlation between m-OA and CDAI before and after treatment (r = -0.48 vs r = -0.42, P < 0.01). CDAI and d-ROM had decreased significantly by 8 wk after treatment (CDAI; 223.3 ± 113.2 vs 158.3 ± 73.4, P < 0.01, d-ROM; 373 ± 133 vs 312 ± 101, P < 0.05). However, neither BAP nor m-OA had changed significantly. In patients who had responded to the treatment at 8 wk, d-ROM, BAP, and m-OA levels before treatment did not differ significantly between patients with and without loss of response.

CONCLUSION: Anti-TNF-α therapy decreases oxidative stress in patients with CD, but does not alter the production of antioxidants. Dysregulation of antioxidants may be associated with the disease.

Keywords: Crohn’s disease; Severity; Oxidative stress; Anti-tumor necrosis factor-α antibody

Core tip: We measured serum markers of oxidative stress (d-ROM) and antioxidant potential (BAP) prior to and 8 wk after the initial administration of infliximab or adalimumab in CD. As a consequence, d-ROM decreased significantly after treatment. However, BAP and the ratio of oxidative stress and antioxidant potential remained unchanged. Anti-tumor necrosis factor-α therapy decreases oxidative stress, but does not alter the production of antioxidants. Dysregulation of antioxidants may be associated with CD.