Inflammatory Biomarker Series: Antioxidants
So far in our inflammatory biomarker series, we have considered the clinical significance of measuring rheumatoid factor (RF) and C-reactive protein (CRP) to detect inflammation. Inflammation, either chronic or acute, is the body’s immune response to protect against harmful stimuli such as damaged cells, irritants or pathogens and can be present in a range of diseases and conditions.1 Measuring inflammatory biomarkers can assist clinicians in the identification of a particular disease or can provide a marker of treatment response. In this blog, we consider the role of antioxidants and identify relevant biomarkers which may be linked to inflammatory states.
What is an antioxidant?
An antioxidant is a molecule that inhibits the oxidation of other molecules. Oxidation is a chemical reaction that produces free radicals, which are groups of very reactive molecules that can interrupt important cellular processes. Antioxidants are commonly referenced with regards to food, however antioxidants are also found in the body in the form of enzymes. Their purpose is to protect against the effects of oxidative stress to reduce damage from free radicals.
What is the link between antioxidants and inflammation?
Oxidative stress and the inflammation associated with it are the cause of most human disease. This would suggest that free radicals are implicated in many disease states for example rheumatoid arthritis, asthma, stroke, or cancer. Therefore antioxidants are important to protect against oxidative damage, thus reducing the risk of inflammation. There are a number of antioxidants which play a protective role the body, such as ferritin, superoxide dismutase, transferrin, uric acid and glutathione reductase.
Ferritin is responsible for storing iron and releasing it when required. Ordinarily, ferritin is found inside blood cells with only a small amount circulating in the blood. Ferritin is clinically significant at both high and low levels. Low levels of ferritin can highlight an iron deficiency which causes anaemia. Whereas elevated levels of ferritin can be a result of conditions such as rheumatoid arthritis, haemochromatosis, liver disease, metabolic syndrome, type 2 diabetes and renal failure.2 As ferritin is an acute phase reactant, levels will be elevated in any inflammatory state within the body.3
Transferrin is a protein that is responsible for binding and transporting iron in the blood. Transferrin acts as a preventative antioxidant as it binds with free iron, removing it from the bloodstream. This is a critical function, as free iron can stimulate the production of harmful free radicals. As transferrin is a negative acute phase protein, lower levels are associated with inflammatory conditions.7
Superoxide is a by-product of oxygen metabolism and is one of the most damaging free radicals in the body as it can cause cell damage. Superoxide Dismutase (SOD) is an enzyme which catalyses the breakdown of superoxide into a less damaging oxygen or hydrogen peroxide. Therefore SOD preforms a vital defensive function to reduce oxidative stress.4 Extensive research exists which links oxidative stress to chronic inflammation, which can be a contributing factor to diabetes, arthritis, cardiovascular disease and cancer.5 Therefore if levels of superoxide dismutase are low, patients are at risk inflammation, for example, SOD levels are significantly less in rheumatoid arthritis patients.6
Glutathione reductase is found in red blood cells and plays a key role in maintaining cell function and preventing oxidative stress in human cells. Reduced levels of glutathione reductase can contribute to the prevalence of inflammatory states, suggesting that adequate levels of glutathione reductase are essential for optimal function of the immune system. 7, 8
Uric acid is a waste product produced when the body breaks down chemical compounds called purines. It is a scavenging antioxidant that acts by inactivating free radicals. Elevated levels of uric acid is commonly associated with gout, a type of arthritis which is caused when crystals of sodium urate form inside joints causing rapid and painful inflammation.9 Other research has indicated that elevated levels of uric acid is associated with increased risk of cardiovascular disease.
Total Antioxidant Status (TAS)
TAS is a measurement of antioxidant function rather than quantity and considers the cumulative effect of all antioxidants present. The antioxidant defence system has many components, and a deficiency in any of these components can cause a reduction in the overall antioxidant status of an individual.10 Reduction in total antioxidant status has been implicated in several disease states including cancer, CVD, Arthritis and Alzheimer’s disease.
As demonstrated above, different types of antioxidants can help reduce different types of inflammation. Antioxidant tests can be requested from any doctor, who may also review dietary intake, investigate any symptoms and advise if testing is required. If antioxidant levels are found to be inadequate, improving them can be easily done through dietary changes, and can help reduce a body’s overall inflammation.
For health professionals
Randox Laboratories offer a range of diagnostic reagents for antioxidant testing to assist in the diagnosis of inflammatory diseases. Randox offer a complete diagnostic package with applications for a range of biochemistry analysers and a selection of kit sizes, controls and calibrators available. Available tests include: Ferritin, Transferrin, Superoxide Dismutase (Ransod), Glutathione Reductase, Uric Acid, and Total Antioxidant Status (TAS).
- Nordqvist, C., Inflammation: Causes, Symptoms and Treatment. Medical News Today, 2015, https://goo.gl/rT4WS9 (accessed 16 January 2017)
- Koperdanova, M., Interpreting raised serum ferritin levels, British Medical Journal, 2015, https://doi.org/10.1136/bmj.h3692 (accessed 2 February 2017)
- Nall, R. Ferritin Level Blood Test, Health Line, 2015, https://goo.gl/XGcW9P (accessed 2 February 2017)
- Yasui, K. and Baba, A., Therapeutic potential of superoxide dismutase (SOD) for resolution of inflammation. Inflammation Research. Vol.55, No.9, pp.359-363, 2006, 1007/s00011-006-5195-y (accessed 2 February 2017)
- Reuter, S., Gupta, S.C., Chaturvedi, M.M., Aggarwal, B.B., Oxidative stress, inflammation and cancer: How are they linked? Free Radic Biol Med. 2010, 1; 49(11):1603-1616 https://goo.gl/Uez3JZ (accessed 2 February 2017)
- Bae SC, Kim SJ, Sung MK., Inadequate antioxidant nutrient intake and altered plasma antioxidant status of rheumatoid arthritis patients. J Am Coll Nutr. 2003 Aug;22(4):311-5
- Reynolds, B., Glutathione for inflammatory respsonse, FX Medicine, 2015, Available from: https://goo.gl/2YAv5l (accessed 3 February 2017)
- Morris, G., Anderson, G., Dean, O. et al., The glutathione system: a new drug target in neuroimmune disorders. Mol Neurobiol 2014;50(3):1059-1084, Available from: https://goo.gl/PDSgwv (accessed 3 February 2017)
- Malaghan Institute, Uric acid – a new look at an old marker of inflammation, Malaghan Institute of Medical Research, 2013, Available from: https://goo.gl/P6NfXP
- Li, Y., Browne, R.W., Bonner, M.R., Deng, F., Tian, L., Mu, L., Positive Relationship between Total Antioxidant Status and Chemokines Observed in Adults. Oxid Med Cell Longev. 2014, Available from: https://goo.gl/rmj5MB (accessed 9 February 2017)
Did you know that one of the reasons we entered into partnership with the Jockey Club is because we are experts in the field of Equine Health?
Well now you do!
Not only do we have a history of being involved in equestrian events, (we host the Randox Point-to-Point event for our local community every year, and International Polo Tournaments in both Scotland and Bushmills, on the Causeway Coast of Northern Ireland), but we also have over 34 years’ experience in the diagnostics industry, during which we have developed innovative and accurate diagnostic products for Equine Health.
That may sound complicated but vets, trainers and owners have been working with us for years so that we can help them better understand their horses’ health and wellbeing.
To recognise the importance of what we do, you must know that more than 70% of all medical decisions are based on an analysis of your blood.
Using our innovative blood-science technology we can obtain a comprehensive profile of not only your body’s current health, but also your future health. This is the same for horses!
In the development of our own dedicated Equine Health Programme, we’ve learnt a thing or two. We know that endurance racehorses require extra attention as a result of intense physical exercise, and therefore monitoring what’s going on in their blood is vitally important.
To give an example, monitoring the Total Antioxidant Status of your horse is a sure-fire way to detect whether he or she has suffered muscle cell injury or trauma.
A reduction in the overall antioxidant status of your horse inhibits its body’s defence and monitoring the TAS is therefore an efficient way to identify risk of injury, determine the levels of training required and establish appropriate recovery times to maintain their wellbeing.
If your horse is often transported between locations it’s also important to monitor his or her TAS. The Total Antioxidant Status of a horse may increase after long-haul road transportation, indicating that your horse is stressed.
So, as you can see, you can tell a lot about the health of your horse by looking at what’s going on in their blood. We’re the experts in this area so we can share our knowledge with you, explain the importance of particular biomarkers in observing the health of your horse, and advise you what areas of your horse’s health you should be monitoring if you have particular concerns.
Let’s say for example your horse is undergoing intense training.
We would recommend that you monitor their levels of Superoxide Dismutase. This enzyme can let you know whether they are suffering from any muscle pain, stiffness, joint weakness, loss of muscle strength, stamina and flexibility, amongst other issues. It is important to know whether their current training is regime is benefitting them, or encumbering them.
If injury is suspected, we then advise that you monitor your horse’s levels of Creatine Kinase.
Any damage to your horse’s heart, skeletal muscle or brain tissue will result in a spike of Creatine Kinase in the blood. By monitoring CK, you can determine any muscle trauma, bruising, wasting, abscesses, inflammation, infection and recurring muscle damage.
Laminitis, a painful inflammatory condition of the tissue, is often one of the most concerning conditions for any horse, as historically there has been minimal opportunity to detect the risk or early stages of the disease. Randox Adiponectin, a protein hormone, is now being used in conjunction with other current biomarkers to successfully detect the risk of this disease and allow earlier management of the condition in the aim to remove the risk completely or reduce its life-altering impact.
The importance in monitoring these biomarkers is of course that it enables early treatment, which greatly improves your horse’s prognosis and chances of recovery.
Swift treatment upon diagnosis of trauma ensures that your horse is kept healthy and happy, and our customers agree! We work with a number of key Veterinary Hospitals around the world, including Rood and Riddle Equine Hospital, the Official Equine Hospital of the Breeders’ Cup in Lexington, Kentucky, (known as ‘The Horse Capital of the World!), and The Irish Equine Centre in Kildare, Ireland.
Jean Hearn, Biochemistry Lab Manager at The Irish Equine Centre, commented;
“As a long time customer of Randox Laboratories, over thirty years, I feel I am in a good position to offer an opinion on the company. Initially we dealt with Randox for Chemistry Reagents and ELISA kits, as they offered a very good range for us working in the veterinary field. However when they launched their Randox Daytona, we found it to be an essential additional analyser in our laboratory, due to the fact that it was capable of running tests that prior to that we were running with very labour intensive methods. eg various minerals and it also broadened the range of tests we could offer to our customers ,eg. acute phase proteins.
“Support has always been good from Randox and the staff always very pleasant and helpful.”
Of course what your horse eats plays a huge role in their health too.
High quality horse feed is paramount for race horses in particular whose speed, agility and most importantly, health, is dependent on them receiving all the nutrients they require.
Our Randox Food Diagnostics ensures the safety of horse feed by screening the food for harmful mycotoxins which can grow on a variety of different crops including cereals, grains and fruits, and can cause a number of health issues for horses, including problems with fertility, sports performance and malnutrition.
And our work in the racing industry doesn’t stop there.
Our Randox Toxicology division creates custom testing panels for the screening of drugs of abuse, on our patented Randox Biochip Array Technology, which has revolutionised the diagnostics industry by allowing multiple tests to be run simultaneously on a single, undivided patient sample.
Screening for drug abuse amongst jockeys in this way (we currently work with Jockey Clubs around the world including Sha Tin racecourse in Hong Kong) protects the safety of the horses and ensures races are won on the jockeys’ and the animals’ natural abilities.
Hopefully you now have a flavour for the work that we do in the racing and veterinary industries to ensure the health and wellbeing of horses. We hope that through our sponsorship of the Randox Health Grand National we can share our knowledge and expertise in the field of Equine Health, Horse Feed Screening and Jockey Toxicology with the racing fraternity.
Just as we promote a message of preventive health to racing fans, the same applies to the horses we love.
For further information on how we work to keep horses healthy, please contact our Randox PR Team.
T: 028 9445 1016