Importance of systemic redox homeostasis biomarkers and transcription factors in patients undergoing open-heart surgery with cardiopulmonary bypass.

Abstract

Purpose: Patients undergoing coronary artery bypass graft surgery and isolated valve disease surgery may experience redox dyshomeostasis associated with cardiopulmonary bypass (CPB).

Methods: We investigated the impact of CPB on systemic redox homeostasis by analyzing redox biomarkers and antioxidant transcription factors preoperatively and postoperatively using spectrophotometric and immunochemical methods.

Results: Our findings indicate significant variations in protein oxidation biomarkers, antioxidant capacity biomarkers, and transcription coactivator peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α) levels after CPB. The ROC analysis indicated that protein carbonyl was valuable in the preoperative (p = 0.009) and postoperative (p = 0.013) periods. We also found that glutathione peroxidase was a valuable redox biomarker during the postoperative period (p = 0.000). An ROC analysis of catalase activity (p = 0.017) before CPB indicated the importance of catalase in eliminating increased hydroperoxide load. The ROC graphs reinforced the value of PGC-1α (p = 0.000) as a biomarker, showing a similar trend to that of catalase before CPB.

Conclusion: The earlier view of "increased oxidative stress and decreased biofunction" has shifted to exploring the physiological role of redox signaling regulation. We believe that future studies on the effects of CPB on systemic redox regulation processes through redox signaling mechanisms will significantly contribute to the relevant literature.