Abstract
P>Background
Podoconiosis (endemic nonfilarial elephantiasis) occurs in susceptible individuals who go barefoot in regions of irritant volcanic soil. Silicate particles absorbed via the skin are thought to induce an inflammatory process and a consequent endolymphangitis of the lower leg lymphatics.
Objectives
To establish which oxidative stress biomarkers play a part in the inflammatory process, and to test whether transforming growth factor (TGF)-beta 1 also has a pathogenetic role.
Patients and methods
We enrolled 50 patients with early clinical stage disease, 43 patients with advanced stage disease and 35 local healthy controls. Oxidative stress biomarkers included serum total peroxides (TP), total antioxidant capacity (TAC), total nitrate plus nitrite (TN), malondialdehyde (MDA) and total superoxide dismutase (SOD) activity. The oxidative stress index (OSI) was also determined. Serum total TGF-beta 1 was assayed using sandwich enzyme-linked immunosorbent assay.
Results
Compared with healthy controls, patients with early stage disease showed significantly higher mean levels of TP (P < 0 center dot 001), MDA (P < 0 center dot 05) and OSI (P < 0 center dot 01); and significantly lower mean concentrations of SOD (P < 0 center dot 001) and TGF-beta 1 (P < 0 center dot 001). Mean levels of TGF-beta 1 were even lower among patients with advanced stage disease (P < 0 center dot 001). Mean TAC levels were significantly lower among patients with advanced disease than either other group (P < 0 center dot 001).
Conclusions
This is the first study, to our knowledge, to attempt to elucidate the molecular pathogenetic events in podoconiosis. We conclude that TGF-beta 1 may have a pathogenetic role, with oxidative stress playing a minor role in the early stages of disease.