Comparison of serum F2 isoprostane levels in diabetic patients and diabetic patients infected with Burkholderia pseudomallei

Introduction Oxidative stress can occur in sepsis and infection, when overproduction of free radicals is not countered by the host antioxidant system, leading to impairment of host cellular functions. Various disease states are accompanied by the accumulation of 15-F2t-IsoP in biological fluids. These isoprostanes are considered as markers of oxidative stress, and inflammation and inflammatory mediators.

Methods We measured total serum 15-F2t-IsoP levels by the immunoassay method in healthy adults, otherwise healthy patients with diabetes mellitus and diabetic patients infected with Burkholderia pseudomallei (B. pseudomallei).

Results The highest mean value of 4,343.6 pg/ml of 15-F2t-IsoP was found in the diabetic melioidosis patients in comparison with the uninfected diabetic patients and the normal controls. Uninfected diabetic patients had significantly higher levels than the control subjects (p-value is less than 0.001), but lower than the diabetic-melioidosis patients (p-value is less than 0.001). The main finding of the present study was an eight-times higher median circulating total IsoPs levels in diabetic patients infected with B. pseudomallei when compared with the levels in control subjects.

Conclusion The oxidative stress theory proposes that severe sepsis leads to activation of neutrophils and macrophages which subsequently release reactive oxygen-free radicals that may result in lipid peroxidation of endothelial and epithelial cell membrane phospholipids. This chain reaction results in increased levels of isoprostanes, which are thought to contribute to much of the end-stage tissue damage seen in serious infections, such as melioidosis. We believe that this is the first report linking in vivo oxidative stress status and diabetic patients infected with B. pseudomallei.