Antioxidant therapy attenuates oxidative stress in chronic cardiopathy associated with Chagas' disease Leonilda Banki Maçao a , Danilo Wilhelm Filho a, ⁎ , Roberto Coury Pedrosa b , Aline Pereira a , Patrícia Backes a , Moacir Aloisio Torres c , Tânia Silva Fröde d a Departamento Ecologia e Zoologia, Universidade Federal de Santa Catarina, Florianópolis, Brazil b Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil c Departamento de Química, Universidade de São Paulo, São Paulo, Brazil d Departamento de Análises Clínicas, Universidade Federal de Santa Catarina, Florianópolis, Brazil Received 11 September 2006; accepted 12 November 2006 Available online 27 February 2007 Abstract Oxidative stress is common in inflammatory processes of many diseases, including the Chagas' disease, which is characterized by chronic inflammation. The present study is a sequence of a related publication [Oliveira TB, Pedrosa RC, Wilhelm Filho D. Oxidative stress in chronic cardiopathy associated with Chagas' disease. Int J Cardiol in press.] on the same subjects, which showed an increase in oxidative stress associated with the progression of the severity of the disease. Components of the antioxidant system and oxidative biomarkers present in the blood were measured in the same chronic chagasic patients (n = 40), before and after vitamin E (800 IU/day) and vitamin C (500 mg/ day) supplementation for 6 months. Antioxidant enzymes and contents of reduced glutathione in erythrocytes and plasma TBARS contents were analyzed in four groups of patients in different stages of chronic Chagas heart disease (n = 10 each group, groups I, II, III, and IV) according to the Los Andes classification. After the combined vitamin supplementation, TBARS and protein carbonyl levels were decreased in plasma, whilst red cell GSH contents were increased in group I. The vitamin E contents found in the plasma were inversely related to the severity of the disease. No differences in gamma-glutamiltransferase activities were detected but the myeloperoxidase levels were decreased in patients at the initial stages, whilst seric nitric oxide levels were increased in groups II and III. After the antioxidant supplementation, CAT activity was increased in group II, GPx activity was increased in group I, GR activity was increased in groups I and II, whilst the GST activity was decreased in groups II, III and IV. The results clearly indicate that the antioxidant supplementation was able to counteract the progressive oxidative stress associated with the disease. New perspectives for the treatment of Chagas' disease might include an antioxidant therapy in order to attenuate the consequences of oxidative insult related to this disease. © 2007 Elsevier Ireland Ltd. All rights reserved. Keywords: Chagas' disease; Cardiopathy; Antioxidant supplementation; Vitamin E; Vitamin C; Oxidative stress 1. Introduction Recent evidences strongly suggest that oxidative stress damage is associated with the evolution of Chagas' disease [1–5]. Oxidative stress is also implicated in the develop- ment of heart failure [6,7], whilst chronic inflammation is implicated in several diseases [8,9]. In other words, chronic pathological processes and progressive inflammation can lead to alterations in the antioxidant status and to oxidative stress or redox imbalance [8]. As a consequence, the identification of changes in oxidative stress biomarkers involved in Chagas' disease can provide many important contributions to the understanding of cardiac damage in chronic chagasic patients. Chagas' disease is one of the most important medical problems in South America caused by a protozoan parasite, Trypanosoma cruzi [10], which in Brazil involves around International Journal of Cardiology 123 (2007) 43 – 49 www.elsevier.com/locate/ijcard ⁎ Corresponding author. Departamento de Ecologia e Zoologia, CCB, UFSC, Trindade, Florianópolis, 88040-900, Brazil. Tel.: +55 48 3316917; fax: +55 48 3315156. E-mail address: dawifi@ccb.ufsc.br (D.W. Filho). 0167-5273/$ - see front matter © 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2006.11.118