J Asthma. 2014 Aug;51(6):578-84. doi: 10.3109/02770903.2014.892965.

Biomarkers of Oxidative Stress in Acute and Chronic Bronchial Asthma

Sameer Hasan Fatani

Department of Biochemistry, Faculty of Medicine, 6707 Umm AI-Qura University, Abdia, Makkah, K.S.A



Objective: Oxidative stress plays an important role in inflammatory diseases of the airways, such as bronchial asthma. This study highlights the effects of the imbalance of oxidant/antioxidant parameters and their roles in the severity of asthma, in order to target the deficiency of antioxidants when treating asthmatic patients.

Methods: The study included 45 male and 45 female subjects, aged 18 – 48 years, with and without asthma. They were classified into 3 groups: G1 was healthy volunteers (CT, n=15), G2 included patients with stable (chronic) conditions of asthma from the outpatients department (OP, n=15), and G3 included patients admitted emergency room (ER, n=15) with acute asthma attacks. For all subjects, the levels of total antioxidant capacity (TAC), reduced glutathione (GSH), malondialdehyde (MDA), and uric acid were colorimetrically estimated. The correlations between the studied parameters were statistically analyzed.

Results: The levels of TAC and GSH in asthmatic patients, either male or female, were significantly decreased in the ER more than in the OP group as compared to the control (P<0.001). MDA increased significantly in the ER group and over the OP group when compared with healthy subjects. Significant positive correlations (P<0.001) were observed between MDA and other studied parameters TAC (r=-0.74), GSH (r=-0.69), and uric acid (r=-0.35).

Conclusions: The levels of total antioxidants were inversely related to the severity of asthma as observed in asthmatic patients visiting outpatient clinics and patients with acute asthmatic attacks admitted to emergency rooms. Meanwhile, those patients with acute attacks showed increased oxidative stress as reflected in the raised MDA levels.

KEYWORDS: Bronchial asthma; malondialdehyde; reduced glutathione; total antioxidant capacity; uric acid

PMID: 24593289



Worldwide more than 600 million people have been diagnosed as bronchial asthma patients with incidence 10% (childhood) and 5% (adults). According to last reports, the incidence of asthma in KSA was 8%. The mechanism of airway obstruction is not completely understood. The oxidative stress that produced by free radicals are involved in the pathological changes of asthma and increase the frequency of its attacks. There are some studies involved the effects of oxidative stress in bronchial asthma. While according to our knowledge, there is no study discussed the diagnostic role of oxidative stress’s biomarkers and how can be used to differentiate between the acute and chronic cases of bronchial asthma. In addition, the correlation of oxidants/antioxidants parameters was studied. The changes in the oxidant and antioxidant capacity related to sex were evaluated in current study.

Generally, there were significant increase in MDA levels and significant decrease in the total antioxidant capacity TAC in acute and chronic (much more prominent) asthmatic patients compared to healthy subjects. In the current study and with the same manner of TAC, the levels of GSH were decreased gradually according to this order healthy, acute, and chronic. This data reflected the direct relationship between a status of high oxidants and poor antioxidant defense in asthmatic patients and impact of this imbalance in the severity of attack. The positive correlation of TAC & GSH levels (r = 0.59) confirms our suggestion that the decrease of GSH levels leads to a decrease in the antioxidant capacity in asthmatic patients that correlated with the severity of attack. In addition, the negative correlations of MDA and other studied parameters (TAC, GSH, and uric acid) provides an evidence that the imbalance between the oxidative stress and the antioxidant defense systems is able to exert a variety of pathological changes that have a highly impact in the severity of asthma. There are strong correlations between antioxidant-oxidant parameters suggests strong correlations between asthma severity and antioxidant defense might exist.

The importance of this study:

  • The study involved 2 groups of asthma patients according to the severity of the attack; acute and chronic groups. Previously, few studied discussed the role of oxidative stress in bronchial asthma as general, while this study focused on the use of oxidative stress biomarkers as indication of the severity of attack and to differentiate between acute and chronic asthma patients.
  • The study evaluates the effect of sex (male and female) on the severity of attack. The results show no significant difference between male and female in the levels of oxidative stress biomarkers or even in the severity of attack.
  • The impact of the investigated correlations between oxidant and antioxidant parameters is reflect the important role of oxidative stress biomarkers as novel diagnostic tools to determine the severity of bronchial asthma attack.



Dr. Sameer Hasan Fatani,

Department of Biochemistry, Faculty of Medicine,

6707 Umm AI-Qura University, Abdia, Makkah, K.S.A.

Tel.: 00966-25270000/ 4495

Mobile: 00966-542336059

Fax: 00966-25270000/4319

e-mail: shfatani@uqu.edu.sa; Sameer_fatani2003@yahoo.co.uk


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