Thiol-disulfide homeostasis and ischemia-modified albumin in patients with sepsis

Abstract Objectives Sepsis is an organism’s exaggerated response causing physiological and pathological biochemical changes. This study aims to investigate the alterations in thiol/disulfide ratio (TD) and ischemia-modified albumin (IMA), as well as their association with acute phase reactants in sepsis patients. Methods The study was conducted in the Anesthesia and Resuscitation Intensive Care Unit between October 1, 2023, and October 30, 2024, and included 66 patients, 29 women and 37 men. Patients were classified according to their Sequential Organ Failure Assessment (SOFA) scores. The parameters measured in this study included C-reactive protein (CRP), procalcitonin (PCT), native thiol, total thiol, disulfide, disulfide/native thiol × 100, disulfide/total thiol × 100, native thiol/total thiol × 100 ratios and IMA. Results In the SOFA<10 group, acute phase reactants such as CRP and PCT were elevated on day 0; however, these levels decreased significantly on days 3 and 7. In the SOFA≥10 group, all measured values decreased on day 7, although the changes were not statistically significant (p>0.05). IMA values were significantly higher on day 0 (p<0.05). In both groups, patients had elevated levels of total thiols, native thiols, and IMA, suggesting increased antioxidant levels. Conclusions Our study’s findings indicate that IMA and TD are involved in the pathogenesis of sepsis in patients.