The role of curcumin as an inhibitor of oxidative stress caused by ischaemia re-perfusion injury in tetralogy of Fallot patients undergoing corrective surgery.

BACKGROUND: Cardiopulmonary bypass during tetralogy of Fallot corrective surgery is associated with oxidative stress, and contributes to peri-operative problems. Curcumin has been known as a potent scavenger of reactive oxygen species, which enhances the activity of antioxidants and suppresses phosphorylation of transcription factors involved in inflamation and apoptosis. OBJECTIVES: To evaluate the effects of curcumin as an antioxidant by evaluating the concentrations of malondialdehyde and glutathione, activity of nuclear factor-kappa B, c-Jun N-terminal kinase, caspase-3, and post-operative clinical outcomes. METHODS: Tetralogy of Fallot patients for corrective surgery were randomised to receive curcumin (45 mg/day) or placebo orally for 14 days before surgery. Malondialdehyde and glutathione concentrations were evaluated during the pre-ischaemia, ischaemia, re-perfusion phases, and 6 hours after aortic clamping-off. Nuclear factor-kappa B, c-Jun N-terminal kinase, and caspase-3, taken from the infundibulum, were assessed during the pre-ischaemia, ischaemia, and re-perfusion phases. Haemodynamic parameters were monitored until day 5 after surgery. RESULTS: In all the observation phases, malondialdehyde and glutathione concentrations were similar between groups. There was no significant difference in nuclear factor-kappa B activity between the groups for three observations; however, in the curcumin group, c-Jun N-terminal kinase significantly decreased from the pre-ischaemia to the re-perfusion phases, and caspase-3 expression was lower in the ischaemia phase. Patients in the curcumin group had lower temperature and better ventricular functions, but no significant differences were found in mechanical ventilation day or length of hospital stay in the two groups. CONCLUSION: Cardioprotective effects of curcumin may include inhibition of the c-Jun N-terminal kinase pathway and caspase-3 in cardiomyocytes, particularly in the ischaemia phase.

Human ß-defensin 2 concentration of respiratory tract mucosa in elderly patients with pneumonia and its associated factors.

AIM: to identify HBD2 peptide in sputum of patients with pneumonia; to obtain mean concentration difference of HBD2 between elderly patients and the younger adults with pneumonia; and to find any association between age, nutritional status, smoking habits, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) and the concentration of HBD2 in patients with pneumonia. METHODS: a cross-sectional study with consecutive sampling technique was conducted in 23 elderly patients and 38 younger adults with pneumonia who were hospitalized in Cipto Mangunkusumo Hospital, Jakarta. Patients with pulmonary and respiratory tract malignancy, taking long-term corticosteroid and/or immunosuppressant therapy were excluded. The sputum of patient was taken spontaneously or by sputum induction technique and prepared for identification by dissolving with dithiothreitol (DTT) solution. The presence of HBD2 was identified by using SDS-PAGE and immunoblotting; while the concentration was measured by ELISA. The mean difference of HBD2 concentrations between elderly patients and the young adults was analyzed using t-test. Chi-square test was performed to analyze the association between several risk factors and HBD2 concentrations in the sputum. RESULTS: the mean concentration of HBD2 in the sputum of all subjects was 178.98 (SD 49.55) pg/ml. There was no mean concentration difference of HBD2 between elderly and younger adult patients with pneumonia. Age, nutritional status, smoking habit and diabetes mellitus were not associated with HBD2 concentration; however, COPD was associated with HBD2 concentration (p-value = 0.014). CONCLUSION: there is no mean concentration difference of HBD2 in the sputum of elderly and younger adult with pneumonia. There is association between COPD with HBD2 concentrations in the sputum of patients with pneumonia.