Assessment of the activity of the antioxidant barrier in children and adolescents with gastroesophageal reflux disease

Introduction: An oxidative stress is a balance disorder between the intensity of oxidative processes, which induce the creation of reactive forms of oxygen (RFO) and a counteracting defense system – an antioxidant one. Free radicals play an important role in the pathology of the diseases of the alimentary system. An increased migration of neutrophiles is suspected to lie at the base of an inflammatory state in the area of the esophageal mucosa, in the course of the gastroesophageal regurgitation. Aim of the study was an attempt at answering the question whether in patients with symptoms of the gastroesophageal reflux, in whom the gastrophageal reflux disease was diagnosed on the basis of the pH-impedance analysis, and in patients without the gastrophageal reflux disease, there appears an increased generation of active forms of oxygen. Material and methods: The research comprised a group of 136 children aged 4-18 years of both sexes, the patients of the Chair and Department of Pediatrics, Allergology and Gastroenterology in Bydgoszcz, admitted to hospital with the suspicion of the gastroesophageal reflux disease. The criterion for including patients into the research was their not using anti-excretory medications for the period of at least 2 weeks. The comparative group included 20 patients of both sexes under the medical care of the Cardiology Outpatient Clinic, who were admitted to the Department in order to conduct a medical check-up. The analysis of the 24-hour pH-impedance with the use of the apparatus and polyvinyl probes took place in hospital conditions. Every patient’s blood was collected from their ulnar vein for the purpose of routine laboratory tests (such as the blood cell count with smear and CRP). Additionally, 11 ml of blood was collected in the morning hours (6 ml for an anticoagulant and 5 ml for a clot), the aim being to mark the indexes of the aerobic metabolism. The results of the examination underwent a statistical analysis. Results and conclusions: No dependence was indicated between the selected parameters of the oxidative stress (MDA, SOD, CAT, GPx) and the group of patients with the gastroesophageal reflux disease and without the gastroesophageal reflux, but it has been discovered that the mean MDA level in plasma is significantly bigger in the control group, however the level of SOD parameter is bigger in the group with a gastroesophageal reflux disease.