Keywords: acid-dependent pathology, gastroesophageal reflux disease, oxidative stress, antioxidant protection, glutargin


Introduction. Gastroesophageal reflux disease (GERD) and peptic ulcer (PU) of the duodenum belonging to the group of acid-dependent diseases (ADD) remain the most common among gastroenterological pathologies. The main pathogenic component of the diseases, leading to the development of abrasions and relapses, is oxidative stress. The search for drugs that can effect the antioxidant defense systems in patients with ADD is actual.

The aim of the study – to investigate the state of oxidative homeostasis systems in patients with acid-depen­dent diseases during treatment using basic regimens and adding glutargin to the basic therapy.

ResearchMethods. 28 patients with GERD and 23 patients with GERD combined with PU duodenum were examined. Depending on the therapeutic regimens, each group is divided into 2 sub-groups: patients receiving basic treatment, and patients with treatment on traditional scheme with adding glutargin. Before and after the treatment, TBA-active products, activity of superoxide dismutase (SOD), catalase (Cat), glutathione peroxidase (GPO), glutathione reductase (GR), the content of reduced glutathione (GSH) were determined in the blood of the patients.

Result and Discussion. Analysis of the treatment data for patients with ADD indicates that the inclusion of glutargin in the basic therapy in patients with GERD and in patients with GERD combined with PU duodenum led to a significant decrease in TBA-active products both plasma and erythrocytes against the background of activation of SOD, Cat, indicators of the glutathione system. In patients who did not receive glutargin, the imbalance in the oxidative homeostasis system was not eliminated. The pharmacological effect of glutargin is related to the active ingredients that make up its composition, namely, L-arginine and L-glutamate. Antioxidant and membrane stabilizing properties of L-arginine are realized by means of NO-regulating system, L-glutamate activates the synthesis of glutathione.

Conclusions. The use of traditional basic therapy in patients with acid-dependent diseases did not eliminate manifestations of oxidative stress, as evidenced by the lack of reliable changes in the indices of lipid peroxidation systems and antioxidant protection. The inclusion of glutargin in the basic treatment of patients with gastroesophageal reflux disease and patients with gastroesophageal reflux disease combined with peptic ulcer of the duodenal ulcer allowed them to level out the depression of the enzyme antioxidant link, to raise recovered glutathione level and normalize lipoperoxidation processes parameters.


El-Serag, H.B., Sweet, S., Winchester, C.C., & Dent, J. (2014). Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut, 63 (6), 871-880.

Lanas, A., & Chan, F.K.L. (2012). Peptic ulcer disease. The Lancet, 390, (10094), 613-624.

Komarchuk, V.V. (2012). Otsenka kachestva zhizni patsiyentov pri oslozhnennykh formakh yazvennoy bolezni v sochetanii s reflyuksnoy boleznyu [Assessment of the quality of life of patients with complicated forms of peptic ulcer in combination with reflux disease]. Klіnіchna hіrurhіia – Clinical Surgery, 10, 62-64 [in Russian].

Yandrapu, H. & Sarosiek, J. (2015). Protective factors of the gastric and duodenal mucosa: An overview. Current Gastroenterology Reports,17 (6), 24.

Barinov, E.F., Kondratenko, P.G., Sulayeva, O.N., Yarikov, S.O., & Delyy, V.Yu. (2013). Gastrointestinalnyy baryer: strukturnyye i molekulyarnyye determinanty v norme i pri ultserogeneze [Gastrointestinal barrier: structural and molecular determinants in norm and in ulcerogenesis]. Ukrainskyi zhurnal khirurhii – Ukrainian Journal of Surgery, 23 (4), 96-104 [in Russian].

Bhattacharyya, A., Chattopadhyay, R., Mitra, S., & Crowe, S.E. (2014). Oxidative stress: an essential factor in the pathogenesis of gastrointestinal mucosal diseases. Physiological Reviews, 94 (2), 329-354.

Kwiecien, S., Jasnos, K., Magierowski, M., Sliwowski, Z., Pajdo, R., Brzozowski, B., Mach, T., Wojcik, D., & Brzozowski, T. (2014). Lipid peroxidation, reactive oxygen species and antioxidative factors in the pathogenesis of gastric mucosal lesions and mechanism of protection against oxidative stress – induced gastric injury. Journal of Physiology and Pharmacology, 65 (5), 613-622.

Butorin, N.N., Bichurina, T.B., Vasjutin, A.V., Solodenova, M.E., Onuchina, E.V., Tonkikh, Yu.L., & Cukanov, V.V. (2015). Rol oksidativnogo stressa v pato­geneze gastroezofagealnoy refliuksnoy bolezni [Role of oxidative stress in the pathogenesis of gastroesophageal reflux disease]. Klinicheskaya gastroenterologiya – Clinical Gastroenterology, 3, 17-20 [in Russian].

Freedberg, D.E., Lawrence, S. & Yang, Yu-Xiao (2017). The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association. Gastroenterology, 152, 706-715.

Kamisah, Y., Qodriyah, H.M., Chua, K.H., Nur Azlina, M.F. (2014) Vitamin E: a potential therapy for gastric mucosal injury. Pharmaceutical Biology, 52 (12), 1591-1597.

Ovsiannikova, M.M., Alokhіna, S.M., & Drobіn­ska, O.V. (1999). Bіokhіmіchnі ta bіofіzychnі metody otsіnky porushen okysliuvalnoho homeostazu v osіb, shcho zaznaly radіatsіinoho vplyvu vnaslіdok avarіi na ChAES (metodychnі rekomendatsіi) [Biochemical and biophysical methods for evaluating the disturbances of oxidative homeostasis in persons who have undergone radiation influence as a result of the Chernobyl accident (methodical recommendations)]. Kyiv [in Russian].

Barkovskiy, E.V., Bokut, S.B., Borodinskiy, A.N., Buko, V.U., Valentyukevich , O.I., Gritsuk, A.I., & Chir­kin, A.A. (2013). Sovremennye problemy biokhimii. Metody issledovaniy [Modern problems of biochemistry. Research Methods]. Minsk: Vyshaya Shkola [in Russian].

Pereslegina, I.A. (1989). Aktivnost antioksidantnykh fermentov slyuny u zdorovykh detey [Activity of antioxidant saliva enzymes in healthy children]. Laboratornoe delo – Laboratory Work, 11, 20-23 [in Russian].

Ponomarenko, L.A., Lykholat, O.A., & Ponomarenko, O.A. (2011). Osoblyvosti system antyoksydantnoho zakhystu u khvorykh iz kyslotozalezhnoiu patolohiieiu [Features of antioxidant protection systems in patients with acid-dependent pathology.] Dosiahnennia biolohii ta medytsyny – Achievements of Biology and Medicine, 1 (17), 33-37 [in Ukrainian].

Babak, O.Ya., Frolov, V.M., & Harchenko, N.V. (2005). Glutargin – farmakologicheskoe deystvie i klinicheskoe primenenie [Glutargin - pharmacological action and clinical application]. Kharkov: Elton-2 [in Russian].

How to Cite
Ponomarenko, L. A., Lykholat, O. A., & PonomarenkoО. A. (2018). CHANGES OF INDICATORS OF OXIDATIVE STRESS IN PATIENTS WITH ACID-DEPENDABLE DISEASES IN TREATMENT. Medical and Clinical Chemistry, (3), 84-89.