Effectiveness of Vitamin E and Molecular Hydrogen-Rich Water on Radiation Therapy-Induced Adverse In Adult Patients With Rectal Carcinoma in Al-Quds, Palestine

Tumor necrosis factors (TNF)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

TNF refer to a group of cytokines which are mainly secreted by monocytes/macrophages. While it was first recognized for its anti-tumor activity, TNF has since been identified as a highly pleiotropic cytokine that mediates multiple cellular processes including inflammation, cell differentiation, cell survival and proliferation, and apoptosis. The master pro-inflammatory cytokine, TNF, has been shown to modulate multiple signaling pathways, with wide-ranging downstream effects. TNF plays a vital role in the typical immune response through the regulation of a number of pathways encompassing an immediate inflammatory reaction with significant innate immune involvement as well as cellular activation with subsequent proliferation and programmed cell death or necrosis.

Matrix metalloproteinases(MMPs)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

MMPs are members of metzinc in group of zinc dependent endopeptidases which are responsible for degrading and remodeling of extracellular matrix (ECM) during organogenesis, wound healing, angiogenesis, apoptosis, cell proliferation and cancer progression. The expression and activity of MMPs in adult tissues is normally quite low, but increases significantly in various pathological conditions that may lead into unwanted tissue destruction, such as inflammatory diseases, tumour growth and metastasis. MMPs are produced by multiple tissues and cells. MMPs are secreted by connective tissue, pro-inflammatory, and uteroplacental cells.

Superoxide dismutases (SOD)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

SODs are a group of metalloenzymes that are found in all kingdoms of life. SODs form the front line of defense against reactive oxygen species (ROS)-mediated injury. These proteins catalyze the dismutation of superoxide anion free radical (O2-) into molecular oxygen and hydrogen peroxide (H2O2) and decrease O2- level which damages the cells at excessive concentration. This reaction is accompanied by alternate oxidation-reduction of metal ions present in the active site of SODs. During oxidative damage, the level of this enzyme within the tissues is elevated in order to protect them. SOD converts O2- into H2O2.

total blood count

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

A hematology analyzer is commonly used to investigate changes in hematological parameters, which vary in response to systemic changes. These hematological parameters include WBCs, which defend the body against foreign invaders; their numbers increase during inflammation. RBCs contain hemoglobin, which carries oxygen to the tissues. Platelets have a hemostatic function. During injury, they gather at the site of damage in blood vessels and form a primary platelet plug. Bleeding occurs when the platelet count decreases.

Glutathione S-transferase (GST)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

GST isoenzyme superfamilies detoxify a wide-range of toxic chemicals and environmental substances are extensively expressed in mammalian tissues. GSTs play a key role in the deactivation of reactive oxygen species (ROS) and the metabolism of lipids, chemotherapeutic agents. GSTs are mainly involved in conjugation of reduced glutathione (GSH) with diverse substrates specificity and it is possible that genetic variations in these enzymes will influence cellular response to the environmental agents. GSTs are overexpressed in response to a chemical or oxidative stress as an adaptive physiology and upregulated in cancerous state of organ or tissue. GSTs are essentially involved in susceptibility to various forms of cancer as they are vital in detoxification mechanism to metabolize the environmental carcinogens.

Nuclear factor erythroid 2-related factor 2 (Nrf2)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

Nrf2, a basic leucine-zipper containing transcription factor that plays a key role in the regulation of the production and expression of antioxidant genes in the body. Nrf2 usually combines with the ARE, which is the upstream promoter region of SOD, CAT, GPx, etc. After combination, the enzyme complex upregulate the expression of a serious endogenous protective antioxidant genes in the tissue, thereby maintaining the balance of oxidation and antioxidant levels of the cells.

Catalase (CAT)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

CAT is a common enzyme found in nearly all living organisms, which are exposed to oxygen. The first function assigned to catalase is the transformation of hydrogen peroxide into oxygen and water. It thus plays an important role in defending cells against oxidative damage by degrading hydrogen peroxide. Catalase can modulate the growth rate by various mechanisms, the first obviously being its ability to detoxify H2O2. The second is its ability to bind and protect certain proteins from potential oxidative damage, which in turn are involved in the processes of proliferation and migration. As shown by many reports, catalase and mitochondrial superoxide dismutase control cell growth and migration processes in cancer cells.

Malondialdehyde (MDA)

时间窗: One day before the first day of radiation exposure (initial data) and 2, 6 and 8 weeks post radiation exposure

MDA is one of the consequences of uncontrolled oxidative stress is cells, tissues, and organs injury caused by oxidative damage. It has long been recognized that high levels of free radicals or reactive oxygen species (ROS) can inflict direct damage to lipids. MDA is an end-product generated by decomposition of arachidonic acid and larger PUFAs, through enzymatic or nonenzymatic processes. MDA is highly reactive, capable of inhibiting enzymes that protect cells against the harmful effects of oxidative stress.