Assessment of Paraoxonase-1 Activity, Glutathione, and Oxidative Stress Status in Patients with Rheumatoid Arthritis in Al-Shirqat City
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Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease in which persistent inflammation and oxidative stress interact to promote synovial injury, structural joint damage, and systemic complications. A combined assessment of enzymatic antioxidant defense, intracellular redox reserve, total oxidant burden, and oxidative DNA damage may provide a more integrated picture of redox disturbance than any single marker alone. Objective to assess serum paraoxonase-1 (PON1) activity, reduced glutathione (GSH), total oxidant status (TOS), and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in patients with RA in Al-Shirqat City, Iraq, and to investigate their relationships with disease activity and inflammatory indices. An analytical case-control study included 70 patients with established RA and 70 age- and sex-matched healthy controls. PON1 activity was assessed spectrophotometrically, GSH was quantified in blood by the DTNB-based method, TOS was determined using the Erel colorimetric principle, and serum 8-OHdG was measured by competitive ELISA. Disease activity was evaluated using DAS28-CRP. Compared with controls, RA patients had significantly lower PON1 activity (131.0 ± 53.0 vs. 164.0 ± 59.0 U/L, p = 0.001) and GSH (6.01 ± 0.30 vs. 6.72 ± 0.32 µmol/g protein, p < 0.001), together with higher TOS (7.54 ± 3.21 vs. 5.73 ± 2.81, p = 0.001) and 8-OHdG (5.94 ± 2.80 vs. 3.59 ± 2.00 ng/mL, p < 0.001). 8-OHdG showed the strongest positive association with DAS28-CRP (r = 0.461, p < 0.001). In multivariable analysis, DAS28-CRP and CRP remained independent predictors of 8-OHdG. RA patients in Al-Shirqat demonstrate a coordinated redox disturbance involving impaired antioxidant defenses, increased systemic oxidant load, and enhanced oxidative DNA damage. 8-OHdG showed the closest relationship with disease activity and may be a useful adjunctive biomarker for characterizing the molecular burden of active disease.
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