Активність глутатіонової ферментної системи в студентів із гастроезофагеальною рефлюксною хворобою

Objective — to determine the antioxidant defense systems (ADS) status based on the activity of glutathione enzyme system parameters in young patients with gastroesophageal reflux disease (GERD). Materials and methods. The study involved 45 students from Kharkiv universities with GERD and 20 healthy students of similar age and gender who formed the control group. The average age was (21.9±2.7) years, with a predominance of women — 33 (73.3%). The duration of the disease ranged from «first detected» (17 individuals — 37.8%) to three years (28 patients — 62.2%). The presence of the disease was confirmed by patients’ complaints and the results of endoscopic examination of the esophagus with biopsy and histomorphological analysis of the mucous membrane. Results. The esophagogastroduodenoscopy showed that 34 patients (75.6%) had a non­­erosive form of esophageal disease, and 11 (24.4%) had an erosive form. In patients with the erosive form of GERD, type A was registered in 6 people (54.5%), type B — 4 (36.4%) and type C — 1 (9.1%). It was found that the course of GERD was accompanied by a disturbance in the synthesis of the three components of the glutathione link in the antioxidant defense system (ADS). Thus, glutathione peroxidase (GPX) activity was 1.3 times lower than in the control group ((14.82±0.8 IU/g Hb) versus (18.75±0.9 IU/g Hb)). Glutathione reductase (GTR) content was also reduced by 1.2 times ((1.62±0.3 µmol NADPH/g Hb) versus (1.88±0.4 µmol NADPH/g Hb)), respectively. The activity of reduced glutathione — the main component of the enzyme system — was lowered by 1.2 times (1.53 versus 1.91 mmol/g Hb). A study of these enzymes considering sex, duration of anamnesis and smoking tobacco was conducted. However, these parameters do not affect the indicators. The activity of glutathione system parameters in young patients with GERD depended on the morphological form of esophageal mucosal lesions (it was more pronounced in erosive organ damage). Such changes indicate the formation of cytoprotection defects against the background of a decrease in the activity of the glutathione link of the antioxidant system. The development of GERD at a young age is accompanied by suppression of the level of the glutathione antioxidant system, which promotes chronicity and progression of pathology. Conclusions. The course of GERD in students is characterized by the presence of predisposing factors for both its occurrence and progression. Unbalanced day under load, chronic stress, lack of timely food intake, poor quality food, admiration for carbonated and low­­alcohol drinks, and accumulation in large groups with frequent respiratory diseases lead to stress on the body’s protective systems and contribute to oxidative stress. Exacerbation of GERD in students leads to impaired antioxidant defense by suppressing the activity of key glutathione system components—glutathione peroxidase, glutathione reductase, and reduced glutathione. This may contribute to both prolonged disease exacerbation and the chronic progression of the pathology.