Cumulative effect of systemic inflammation and oxidative stress in 40 known cases of active rheumatoid arthritis


  • Rahul Saxena Department of Biochemistry, SAHS, Sharda University, Greater Noida, UP, India
  • Shilpa Suneja Department of Biochemistry, VMMC & Safdarjung Hospital, New Delhi, India
  • Raj Saxena Department of Clinical Research, Sikkim Manipal University, Manipal, India
  • Dilutpal Sharma Department of Biochemistry, Kings George Medical College, Lucknow, UP, India
  • Alok Milton Lal Department of Biochemistry & Biochemical Engineering, JSB & B, SHIATS, Allahabad, UP, India



Superoxide dismutase, Catalase, Ceruloplasmin, C-reactive protein, Free radical


Background: Oxidative stress has been implicated in the pathophysiology of a number of diseases such as cancer, hypertension and inflammatory diseases. Although previous evidences provided extensive literature about the biological role of antioxidant enzymes in rheumatoid arthritis (RA), there is a paucity of satisfactory explanation regarding the alteration in the level of antioxidant enzymes along with marker of systemic inflammation in RA. The objective of present study was to estimate the level of C-reactive protein (CRP), Superoxide dismutase (SOD), Catalase (CAT), Glutathione peroxidase (GSHPx) and Ceruloplasmin in active RA patients.

Methods: 40 patients of either sex (30-50 years age group) suffering from active RA and 40 normal healthy individuals served as control; were included in the study. Above mentioned parameters were estimated using standard methods and data from patients and controls were compared by using Student’s t-test.

Results: Erythrocyte SOD, CAT and GSHPx activity were significantly low in RA subjects (P<0.001) whereas plasma Ceruloplasmin level was found to be significantly high (P<0.001) as compared to healthy controls.

Conclusions: These findings suggest that combined effect of inflammation and free radical generation is involved in the pathogenesis of active RA, characterized by imbalance in antioxidant enzyme status and enhanced CRP levels, which served as an excellent marker of oxidative stress and systemic inflammation in active RA.


Saxena R. Arthritis as a disease of ageing and changes in antioxidant status. 1st edition, Aging: Oxidative stress and dietary antioxidants, Preedy VP editor, Elsevier publications, Academic press London. 2014:49-59.

Halliwell B. Oxygen radicals, nitric oxide and human inflammatory joint disease. Ann Rheum Dis. 1995;54:505-10.

Dutta J, Sharma D, Saxena R. Oxidative stress mediated electrolyte imbalance in 30 known cases of knee osteoarthritis patients: A clinical approach. Asian J Medical Sciences. 2015;6(5):26-30.

Saxena R, Lal AM. Effect of Aging on antioxidant enzyme status and lipid peroxidation. J Indian Acad Geriat. 2006;2(2):53-6.

Sen CK. Oxygen Toxicity and antioxidants: state of the art. Ind J Physiol Pharmacol. 1995;39(3):177-96.

Greenwald RA. Oxygen radicals, inflammation, and arthritis: pathophysiological considerations and implications for treatment. Semin Arthritis Rheum. 1991;20(4):219-40.

Saxena R, Bhattacharya I, Saxena, R. Susceptibility of Knee Osteoarthritic patients to develop Cardiovascular disease. Asian J Medical Sciences. 2013;4(3):62-8.

Marklund S, Marklund G. Involvement of the superoxide anion radical in the autooxidation of pyrogallol and a convenient assay for superoxide dismutase. Eur J Biochem. 1974;47:469-74.

Ravin HA. Photometric method of Ceruloplasmin. J Lab Clin Med. 1961;58:161-3.

Beutler E. Red cell metabolism. A manual of Biochemical methods. 3rd ed. New York: Grune & Strattoa Inc. 1971:112-114.

Goth L. A simple method for determination of serum catalase activity and revision of reference range. Clin Chem Acta. 1991;196:143-52.

Saxena R, Jaiswal G. Selenium and its role in Health and Diseases. Kuwait Med J. 2007;39(1):10-8.

Karatas F, Ozates I, Canatan H, Halifeoglu I, Karatepe M, Colak R. Antioxidant status and lipid peroxidation in patients with rheumatoid arthritis. Indian J Med Res. 2003;118:178-81.

Bhattacharya I, Saxena R, Gupta V. Efficacy of vitamin E in knee osteoarthritis management of North Indian Geriatric population. Therap Adv Musculo Dis. 2012;4(1):11-9.

Aryaeian N, Djalai M, Shahram S, Chamari M, Nazari SA. Beta-Carotene, vitamin E, MDA, glutathione reductase and Arylesterase activity levels in patients with active rheumatoid arthritis. Iranian J Publ Health. 2011;40(2):102-9.

Shadick NA, Cook NR, Karlson EW, Ridker PM. C-reactive protein in the Prediction of Rheumatoid Arthritis in Women. Arch Intern Med. 2006;166(22):2490-4.






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