Oxidative stress is associated with liver damage, inflammatory status, and corticosteroid therapy in patients with systemic lupus erythematosus

Oxidative stress exerts an important role on the pathophysiological mechanisms of systemiclupus erythematosus (SLE). This study investigated oxidative stress in patients with SLE andits correlation with disease activity, corticosteroid therapy, and liver function biomarkers. Thestudyincluded58patientswithSLEand105healthyvolunteers.Patientsshowedoxidativestressincrease evaluated by tert-butyl hydroperoxide-initiated chemiluminescence (CL-LOOH),advanced oxidation protein products (AOPP), and nitric oxide metabolites. C-reactive protein(CRP) was associated with CL-LOOH and with AOPP. Aspartate aminotransferase correlatedsignificantly with CL-LOOH and with AOPP. Patients with disease activity showed an inversesignificantcorrelationofdailyprednisonedosesandCL-LOOHandadirectcorrelationwithtotalantioxidant capacity. Inconclusion, patients withSLE have persistentlipoperoxidationand pro-tein oxidation even with inactive disease or mild disease activity. The significant correlationbetween oxidative stress and CRP suggests that, despite clinical remission, the persistence of aninflammatory condition favors oxidative stress. Oxidative stress was associated with liverenzymes, and this relationship seems to support the hypothesis of drug-induced oxidative stresswith consequent liver injury. In relation to non-active disease, patients with active SLE did notpresent oxidative stress and antioxidant capacity changes, due to the antioxidant drugs used inSLE treatment, especially prednisone. Lupus (2011) 20, 1250–1259.Key words: corticosteroid therapy; liver function; oxidative stress; systemic lupuserythematosus