Participation of the Oxidative Stress in Aortic Valves Associated with Infective Endocarditis; Report of Three Cases

Infective endocarditis (IE) results from infections by gram-positive bacteria, and, in this condition, the redox homeostasis is lost by overproduction of H2O2, leading to overstimulation of the immune system and up- regulation of the production of proinflammatory cytokines. The aim of this preliminary study of three cases with IE, was to evaluate the levels of oxidative biomarkers and of the enzymatic and non-enzymatic antioxidant systems, in subjects with IE. This is a preliminary retrospective analytical study of cases that had undergone aortic valve replacement surgery that was complicated by IE. We determined malondialdehyde (MDA), total antioxidant capacity (TAC), carbonyl groups, glutathione (GSH), thiols and the nitrate/nitrite ratio (NO3−/NO2−) in homogenized tissue of cardiac valves. We also measured the activities of GST, GPx, GR and TrxR. The super oxide dismutase (SOD) isoforms and peroxidase activities were determined using native gels. There were increases in the activities of antioxidant enzymes such as GST, SOD isoforms and peroxidases (p=0.01) and decreases in oxidative stress markers such as GSH, TAC, (p=0.01); however, MDA was increased (p=0.01). The results suggest that loss of the intricate redox homeostasis system in the aortic valve of patients with IE may favor the bacterial process and cause damage probably leading to a fatal outcome.