Spa Therapy and Oxidant Antioxidant Systems 03.06.2015 / Prof Dr Nergis ERDOGAN ISTANBUL 1.

04/18/23 / Prof Dr Nergis ERDOGAN ISTANBUL 1

Spa Therapy and Oxidant Antioxidant Systems

SSpapa T Therapyherapy and and OOxidantxidant A Antioxidantntioxidant

SSystemsystems



• Aerobe organisms produce Reactive Oxygen Species (ROS)

• Superoxide, hydro peroxide and hydroxyl• ROS reactions: Removing atoms, transferring

electrons and adding radicals • Inactivation of enzymes, DNA injury and vital

injury at cell membrane and decrease cell energy

Introduction



ROS play a major role in events like• Inflammatory reactions • Cataract, arteriosclerosis • Intracellular aging, • Cell necrosis and apoptosis, • Ischemia reperfusion injury • Cancer

Introduction



ROS promoters • Physical and psychological stress, • High caloric diet, • Alcohol and cigarette use• Air pollution, ozone • UV light, microwave • Ionizing radiation• Some chemotherapeutic • Hyperthermia treatment also increase ROS

production

Introduction



Aerobe organisms have antioxidant defence systems

Intracellular antioxidant enzyme systems

– Super oxide dysmutase (SOD) catalases, glutathione peroxides

– In vivo synthesizing substances: Bilirubins, sex hormones, melatonine, lipoic acide, coenzyme Q, and uric acid

– Ceruloplasmin, albumin, transferrin, haptoglobin, lactoferrin and hemopexin

Introduction



• A, C and E vitamins and• Plant phenols have antioxidant features• Oxidative stress may results with adaptation

or cell damage• Cells response to mild oxidative stress by

antioxidant defence systems

Introduction



Oxidative stress• Damage DNA and other molecules and cause

degenerative diseases, malignity and aging • Therapy with hyper thermal baths, drinking

cures and peloid packs reduce oxidative stress and induce antioxidant defence

Introduction



The effect of spa therapy on plasma malondialdehit and

total antioxidant levels



Patients and Method • Twenty-eight patients (19 female, 9 male)

primary osteoarthritis • Bursa Military Hospital (Spa group)• Seven patients (5 male, 2 female) İstanbul

Medical Faculty Medical Ecology Hydroclimatology department ambulatory policlinic (Control group)

The effect of spa therapy on plasma malondialdehit and total antioxidant levels



• Spa group patients had 10 –15 minute head out immersion in 39O-41O C thermomineral water, physical therapy and regular exercise for 15 days

• Control patients home exercise and simple analgesics

• Plasma malondialdehit (MDA) and total antioxidant capacity (TAA) were compared




• Fasting blood at the beginning (first measurement) and thirteenth day (15. Day)

• Plasma MDA and TAA levels in Department of Clinical Biochemic by TBARS (Thiobarbituric acid) and FRAP (Ferric Reducing Antioxidant Power Assay) methods




Figure I: Spa group, beginning and 15. Day mean MDA levels (P> 0.05)

0

1

2

3

4

5

6

7M

DA

nm

ol/m

l

The first 15. Day

There was a statistically insignificant decrease Statistically insignificant decrease




0

1

2

3

4

5

6

7

8

9

MD

A n

mo

l/ml

The first 15. Day

Figure II: Spa group, MDA levels at beginning and 15. Day in patients with beginning MDA levels are above

6 nmol/ml ( P< 0.05)

Statistically significant decrease




Figure III: Spa group, MDA levels at beginning and 15. Day in patients beginning MDA levels are below

6 nmol/ml ( P< 0.05)

0

1

2

3

4

5

6

Pla

zma

MD

A n

mo

l/ml

The first 15. Day

Statistically significant increase The effect of spa therapy on plasma malondialdehit and total antioxidant levels



0

200

400

600

800

1000

Pla

zma

TA

A s

ev

iye

leri

µ

mo

l/L

The first 15.day

Figure IV: Spa group the first and15. Day plasma mean TAA levels ( P> 0.05)

No significant differenceThe effect of spa therapy on plasma malondialdehit and total antioxidant levels



0

100

200

300

400

500

600

700

800

900

1000

1100

1200

P l a

z m

a

T A

A

v a

lu

e

µ m

o l /

L

Female Male

The first 15. Day

Figure V: In spa group male and female the first and 15. Day plasma mean TAA values. (P< 0.05)

Statistically significant increase in menStatistically significant decrease in women




Figure VII. Control group the first (5.34±0.65) and 15. Day (4.64±0.96) plasma mean MDA values

0

1

2

3

4

5

6

Mea

n p

lazm

a M

DA

nm

ol/m

l

The first 15. Day

No significant difference




Figure VIII. Control group the first(1065.42±143.27) - 15. day (1243.86±258.46) mean plasma TAA values ( P>0.05 )

No statistically significant difference

0100200300400500600700800900

1000110012001300

Pla

sm

a m

ea

n T

AA

µm

ol/L

The first 15. Day





Spa group (n=28)

Mean

SD

r

P

Disease duration

(Year)

11.61 6.98

The first Plasma

MDA

( nmol/ml)

6.45 2.96

-0.51

0.005

15. day plasma MDA

( nmol/ml)

5.44

0.68

0.002

0.992



DISCUSSION and

CONCLUSION



• Spa therapy decreases oxidant stress ?!• Increases TAA levels in male and • Decreases in females (menopause-estrogens

deficiency?)• Decrease in oxidant stress is more prominent• Increase of antioxidant defence is less

manifest

DISCUSSION and CONCLUSION



• Oxidant effect of hyperthermic baths and antioxidant consumption in defence to oxidative stress

• Disappearance of inverse proportion between disease duration and MDA level

• Balneotherapy more effective in early period of disease in decreasing oxidative stress??!




• Decreasing of MDA levels in patients with high MDA level

• Increasing of MDA levels in patients with low beginning MDA levels

• Regulatory effect of balneotherapy??!!




• Elimination of environmental oxidative factors• Dietary regime • Regular exercise• Physical therapy• Hyperthermic applications • Chemical effects of thermo mineral waters




Thanks for your Thanks for your attention…attention…

Spa Therapy and Oxidant Antioxidant Systems 03.06.2015 / Prof Dr Nergis ERDOGAN ISTANBUL 1.

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