Oxidative Stress in Patients with Chronic Inflammatory Diseases in a Tertiary Health Care Setting in Africa

Oxidative stress has been recently implicated in the pathogenesis of Rheumatoid Arthritis (RA) and Systemic Lupus (SLE). Little is known on oxidative status of these patients in Sub-Saharan Africa. We assessed oxidative stress in 52 RA patients, 29 SLE patients and 72 healthy controls from measuring serum levels of malondialdehyde (MDA), glutathione (GSH) and ferric acid reducing ability of plasma (FRAP) and investigated association of these with disease activity. Oxidant status was high serum MDA or low GSH and anti oxidant status was low plasma FRAP. Patients had higher mean serum MDA compared to controls (0.44 ± 0.37 μmol/l; 0.19 ± 0.93 μmol/l); p=0.036. Mean serum GSH values (0.37 ± 0.35 μmol/l) was lower in patients vs. (0.71 ± 0.20 μmol/l); p<0.001 in controls. Mean serum FRAP values was lower in patients vs. controls (199 ± 100 μmol/l; 212 ± 99 μmol/l; p=0.420). There was a positive correlation between MDA and disease activity DAS-28 (r=0.035, p=0.040), SLEDAI (r=0.136, p=0.241); negative correlation between GSH and disease activity DAS-28 (r=-0.275, p=0.024), SLEDAI (r=-0.063, p=0.373); negative correlation between FRAP and disease activity (DAS-28 (r=-0.103, p=0.233), SLEDAI (r=-0.033, p=0.039). Sub-Saharan African RA and SLE patients have higher oxidant status and lower antioxidant status compared to healthy individuals as described in other settings. Oxidative stress in these patients is associated to disease activity.