Free radicals and Free radicals and thermal water-thermal water-

controlled pilot studycontrolled pilot study

T Bender,G Nagy,J T Bender,G Nagy,J Bariska,R Vághy,R Gomez,I Bariska,R Vághy,R Gomez,I

KovácsKovács

Free radicals play an important role in a number of Free radicals play an important role in a number of biological processes, some of which are necessary for life, biological processes, some of which are necessary for life, such as the intracellular killing of bacteria by neutrophil such as the intracellular killing of bacteria by neutrophil granulocytes.granulocytes.

Free radicals have also been implicated in certain cell Free radicals have also been implicated in certain cell signalingsignaling processes. The two most important oxygen-processes. The two most important oxygen-centered free radicals are superoxide and hydroxyl centered free radicals are superoxide and hydroxyl radical. radical.

They are derived from molecular oxygen under reducing They are derived from molecular oxygen under reducing conditions. However, because of their reactivity, these conditions. However, because of their reactivity, these same free radicals can participate in unwanted side same free radicals can participate in unwanted side reactions resulting in cell damage. reactions resulting in cell damage.

Many forms of cancer are thought to Many forms of cancer are thought to be the result of reactions between be the result of reactions between free radicals and DNA, resulting in free radicals and DNA, resulting in mutations that can adversely affect mutations that can adversely affect the cell cycle and potentially lead to the cell cycle and potentially lead to malignancy. malignancy.

Because free radicals are necessary Because free radicals are necessary for life, the body has a number of for life, the body has a number of mechanisms to minimize free radical mechanisms to minimize free radical induced damage and to repair induced damage and to repair damage which does occur, such as damage which does occur, such as the the enzymesenzymes superoxidesuperoxide dismutasedismutase, , catalasecatalase, , glutathioneglutathione peroxidaseperoxidase and and glutathione reductaseglutathione reductase. .

Antioxidant means "against oxidation." Antioxidant means "against oxidation." Antioxidants work to protect lipids from Antioxidants work to protect lipids from peroxidation by radicals. Antioxidants are peroxidation by radicals. Antioxidants are effective because they are willing to give up their effective because they are willing to give up their own electrons to free radicals. When a free own electrons to free radicals. When a free radical gains the electron from an antioxidant it radical gains the electron from an antioxidant it no longer needs to attack the cell and the chain no longer needs to attack the cell and the chain reaction of oxidation is broken reaction of oxidation is broken

After donating an electron an antioxidant After donating an electron an antioxidant becomes a free radical by definition. Antioxidants becomes a free radical by definition. Antioxidants in this state are not harmful because they have in this state are not harmful because they have the ability to accommodate the change in the ability to accommodate the change in electrons without becoming reactive. electrons without becoming reactive.

The human body has an elaborate The human body has an elaborate antioxidant defense system. antioxidant defense system. Antioxidants are manufactured Antioxidants are manufactured within the body and can also be within the body and can also be extracted from the food humans eat extracted from the food humans eat such as fruits, vegetables, seeds, such as fruits, vegetables, seeds, nuts, meats, and oil. There are two nuts, meats, and oil. There are two lines of antioxidant defense within lines of antioxidant defense within the cell. the cell.

The Aim of our study:The Aim of our study: Does the free radicals change before Does the free radicals change before

and after Balneotherapy?and after Balneotherapy? Is there any change in case of using Is there any change in case of using

tap water?tap water?

Cserkeszölő:(3658mgCserkeszölő:(3658mg)) Kation(Natrium-Kalium 1100mg,Ca Kation(Natrium-Kalium 1100mg,Ca

18,6mg(altogether:1145mg)18,6mg(altogether:1145mg) Anion:Cl 985,Br: 12,5 Jodide: 1,2Anion:Cl 985,Br: 12,5 Jodide: 1,2 HCO:1342,altogether: (HCO:1342,altogether: (2344mg2344mg)) Mórahalom:Mórahalom: Kation:Natrium 520,altogether:532Kation:Natrium 520,altogether:532 Fluorid 1,3, HCO3 1:300mg Fluorid 1,3, HCO3 1:300mg Altogether:(Altogether:(1949mg)1949mg)

MethodMethod Patients:N:30(10 in each group)Patients:N:30(10 in each group) Dg: Spondylosis lumbalisDg: Spondylosis lumbalis They got no NSAID and steroids,no other diseaseThey got no NSAID and steroids,no other disease Duration of the bath 30 minutes T:34 CDuration of the bath 30 minutes T:34 C Blood samples were taken before the first bath, Blood samples were taken before the first bath,

after the first bath and at end of 10 bathsafter the first bath and at end of 10 baths Examination: MDA protein, a Glutathion Examination: MDA protein, a Glutathion

peroxidase, Catalase,and Superoxid dismutase peroxidase, Catalase,and Superoxid dismutase levellevel

Method HCLPMethod HCLP

Results: after the 10. treatmentsResults: after the 10. treatments

MDA Protein Glutathione peroxidase

Superoxid dismutase

Catalase

Debrecen S N.S N.S S Mórahalom S S S S Cserkeszölő S S S S

Explanation:Explanation:

There is difference between tap There is difference between tap waterwater

and mineral water concerning on the and mineral water concerning on the free radicalsfree radicals

The two changes during tap water The two changes during tap water maybe due to the thermal effectmaybe due to the thermal effect

Literatures:Literatures:

Twenty-eight patients (19 female, 9 male) primary Twenty-eight patients (19 female, 9 male) primary osteoarthritis osteoarthritis

Bursa Military Hospital (Spa group) Spa group Bursa Military Hospital (Spa group) Spa group patients had 10 –15 minute head out immersion in patients had 10 –15 minute head out immersion in 39-41 C thermomineral water, physical therapy and 39-41 C thermomineral water, physical therapy and regular exercise for 15 days regular exercise for 15 days

Control patients home exercise and simple analgesicsControl patients home exercise and simple analgesics

Prof Negris Erdogan the effect of spa therapy on plsama MDA and TAA Prof Negris Erdogan the effect of spa therapy on plsama MDA and TAA system(II Hungarian- Turkish Baln. meeting)system(II Hungarian- Turkish Baln. meeting)

Plasma malondialdehit (MDA) and total antioxidant capacity (TAA)Plasma malondialdehit (MDA) and total antioxidant capacity (TAA) were were comparedcompared. . Seven patients (5 male, 2 female) İstanbul Medical Faculty Medical Seven patients (5 male, 2 female) İstanbul Medical Faculty Medical Ecology Hydroclimatology department ambulatory policlinic (Control group)Ecology Hydroclimatology department ambulatory policlinic (Control group)

Oxidant effect of hyperthermic baths and antioxidant consumption in defence to Oxidant effect of hyperthermic baths and antioxidant consumption in defence to

oxidative stressoxidative stress..Disappearance of inverse proportion between disease duration and Disappearance of inverse proportion between disease duration and MDA levelMDA level

Balneotherapy more effective in early period of disease in decreasing oxidative Balneotherapy more effective in early period of disease in decreasing oxidative stress?! Spa therapy decreases oxidant stress ?!Increases TAA levels in male and stress?! Spa therapy decreases oxidant stress ?!Increases TAA levels in male and Decreases in females (menopause-estrogens deficiency?Decreases in females (menopause-estrogens deficiency?))

)Decrease in oxidant stress)Decrease in oxidant stress is more prominentis more prominent..Increase of antioxidant defence is Increase of antioxidant defence is less manifestless manifest

Prof Negris Erdogan the effect of spa therapy on plsama MDA and TAA system(II Hungarian- Turkish Baln. meeting)Prof Negris Erdogan the effect of spa therapy on plsama MDA and TAA system(II Hungarian- Turkish Baln. meeting)

They enrolled 37 subjects and randomly assigned them to two They enrolled 37 subjects and randomly assigned them to two groups: 19 patients underwent mud bath treatment (group A) groups: 19 patients underwent mud bath treatment (group A) while 18 patients underwent bath treatment alone. Blood samples while 18 patients underwent bath treatment alone. Blood samples were obtained before and after the treatment cycles to assay serum were obtained before and after the treatment cycles to assay serum levels of NO, myeloperoxidase (MPO) and glutathione (GSH)-levels of NO, myeloperoxidase (MPO) and glutathione (GSH)-peroxidase.peroxidase.

BellomettiBellometti S S, , PolettoPoletto M M, , GregottiGregotti C C, , RichelmiRichelmi P P, , BerteBerte F F..Int J Clin Pharmacol Res. 2000;20(3-4):69-80. Int J Clin Pharmacol Res. 2000;20(3-4):69-80.

The results showed a statistically significant decrease in NO The results showed a statistically significant decrease in NO and myeloperoxidase serum values in groups A and B, while and myeloperoxidase serum values in groups A and B, while GSH-peroxidase was not significantly increase in either of the GSH-peroxidase was not significantly increase in either of the groups; no correlation was found between NO, groups; no correlation was found between NO, myeloperoxidase and GSH-peroxidase serum values. Mud myeloperoxidase and GSH-peroxidase serum values. Mud bath treatment can exert beneficial effects on cartilage bath treatment can exert beneficial effects on cartilage homeostasis and inflammatory reactions, influencing NO and homeostasis and inflammatory reactions, influencing NO and decreasing myeloperoxidase serum valuesdecreasing myeloperoxidase serum values..

BellomettiBellometti S S, , PolettoPoletto M M, , GregottiGregotti C C, , RichelmiRichelmi P P, , BerteBerte F F..Int J Clin Pharmacol Res. 2000;20(3-4):69-8Int J Clin Pharmacol Res. 2000;20(3-4):69-8

. .

The increase in GSH-peroxidase was not The increase in GSH-peroxidase was not correlated with the reduction of other correlated with the reduction of other biochemical markers, suggesting that mud bath biochemical markers, suggesting that mud bath treatment has different mechanisms of action.treatment has different mechanisms of action.Mud bath therapy influences nitric oxide, Mud bath therapy influences nitric oxide, myeloperoxidase and glutathione peroxidase myeloperoxidase and glutathione peroxidase serum levels in arthritic patientsserum levels in arthritic patients..

BellomettiBellometti S S, , PolettoPoletto M M, , GregottiGregotti C C, , RichelmiRichelmi P P, , BerteBerte F F..Int J Clin Pharmacol Res. 2000;20(3-4):69-80. Int J Clin Pharmacol Res. 2000;20(3-4):69-80.

This study therefore sought to investigate the This study therefore sought to investigate the effect of 3-week therapy with sulfur baths on effect of 3-week therapy with sulfur baths on antioxidative defense systems, peroxide antioxidative defense systems, peroxide concentrations, and lipid levels in patients with concentrations, and lipid levels in patients with degenerative osteoarthritis A 17.2% decline in degenerative osteoarthritis A 17.2% decline in peroxide concentrations (p = 0.10, n.s.) and peroxide concentrations (p = 0.10, n.s.) and significant lower SOD activities (p < 0.001) were significant lower SOD activities (p < 0.001) were detected in the sulfur group at the end of the detected in the sulfur group at the end of the therapy. therapy.

Ekmekcioglu CEkmekcioglu C, , Strauss-Blasche GStrauss-Blasche G, , Holzer FHolzer F, , Marktl WMarktl W. . Effect of Effect of sulfur baths on antioxidative defense systems, peroxide sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative concentrations and lipid levels in patients with degenerative osteoarthritis osteoarthritis Forsch Komplementarmed Klass Naturheilkd. 2002 Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20.Aug;9(4):216-20.

Until the end of therapy total cholesterol Until the end of therapy total cholesterol levels changed differentially (p = 0.007) in levels changed differentially (p = 0.007) in the sulfur group (from 229.11 +/- 34.47 the sulfur group (from 229.11 +/- 34.47 mg/dl to 217.46 +/- 40.45 mg/dl) and in mg/dl to 217.46 +/- 40.45 mg/dl) and in the control group (from 197.63 +/- 34.66 the control group (from 197.63 +/- 34.66 mg/dl to 207.95 +/- 33.02 mg/dl).mg/dl to 207.95 +/- 33.02 mg/dl).

EkmekciogluEkmekcioglu C C, , Strauss-BlascheStrauss-Blasche G G, , HolzerHolzer F F, , MarktlMarktl W W. . Effect of Effect of sulfur sulfur baths on antioxidative defense systems, peroxide concentrations baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis and lipid levels in patients with degenerative osteoarthritis Forsch Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20.Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20.

A similar significant group difference was found A similar significant group difference was found for LDL (p = 0.017), with a 5.9% reduction in the for LDL (p = 0.017), with a 5.9% reduction in the sulfur group and a 6.1% increase in the control sulfur group and a 6.1% increase in the control group. CONCLUSIONS: The results presented here group. CONCLUSIONS: The results presented here suggest that a sulfur bath therapy could cause a suggest that a sulfur bath therapy could cause a reduction in oxidative stress, alterations of SOD reduction in oxidative stress, alterations of SOD activities, and a tendency towards improvement activities, and a tendency towards improvement of lipid levels.of lipid levels...

EkmekciogluEkmekcioglu C C, , Strauss-BlascheStrauss-Blasche G G, , HolzerHolzer F F, , MarktlMarktl W W. . Effect of sulfur baths on Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis patients with degenerative osteoarthritis Forsch Komplementarmed Klass Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20.Naturheilkd. 2002 Aug;9(4):216-20.

Conclusion:Conclusion:

The measurement of free radicals The measurement of free radicals gives valuable informations about gives valuable informations about the possible mechanism of the possible mechanism of balneotherapy and furthers studies balneotherapy and furthers studies need to clarify this topicneed to clarify this topic