ISPUB.COM The Internet Journal of Third World Medicine Volume 7 Number 2 1 of 9 Assessment of salivary and serum oxidative stress and antioxidants as plausible parameters in prediction of ischemic stroke among Iraqi Samples N Al-Rawi, F Jaber, K Atiyah Citation N Al-Rawi, F Jaber, K Atiyah. Assessment of salivary and serum oxidative stress and antioxidants as plausible parameters in prediction of ischemic stroke among Iraqi Samples. The Internet Journal of Third World Medicine. 2008 Volume 7 Number 2. Abstract Background: Oxidative stress is one of the mechanisms involved in neuronal damage induced by free radicals production in ischemic stroke due to ischemia- reperfusion. Antioxidants, on the other hand, may provide protection from neuronal damage caused by oxidative stress. Objectives: The present study was designed to measure some oxidative stress marker and antioxidants in serum and saliva of ischemic stroke patients and patients with some stroke related diseases in an attempt to obtain the predictive value for ischemic stroke in stroke –prone individuals. Methods: Serum and salivary Malondialdehyde (MDA) levels , glutathione (GSH), superoxide dismutase (SOD) and uric acid (UA) were estimated for 150 individuals, fifty of them were patients having recently diagnosed ischemic stroke, seventy five were sex and age matched risk-group patients (patients with hypertension, type2 diabetes and ischemic heart disease ) and other 25 sex and age matched healthy control individuals. Results: Serum GSH is considered as the most powerful predictor for ischemic stroke with critical value (< 1.52µmol/L) followed by serum SOD with critical value ( ≥ 2.09 U/ml) and salivary SOD with critical range ( 1.54-1.80 U/ml) could be an alarming sign for stroke in patients with hypertension and patients with heart diseases. Conclusions: Serum and salivary MDA, SOD, UA and GSH can be used as potential marker for monitoring patients with hypertension, diabetes mellitus and patients with angina or myocardial infarction to give us an idea about the disease progression toward ischemic stroke. INTRODUCTION Stroke (CVA) is considered as a third leading cause of death and an important cause of long-term disability. Ischemic stroke accounts for 80% of all strokes ( 1 ). Several mechanisms have been suggested in the pathogenesis of ischemic stroke. Oxidative stress is one of the mechanisms involved in neuronal damage induced by free radicals production due to ischemia-reperfusion ( 2 ). Oxidative stress is an imbalance between the generation of free radicals and antioxidant defense capacity of the body. This resulted in the alteration of the cellular components in term of DNA break, cytotoxicity and lipid peroxidation ( 3 ). Lipid peroxidation is the most common and most hazardous reaction encountered as a result of free radical generation ( 4 ). Lipid peroxidation is measured by lipid hydro peroxides ( 5 ) which are unstable and degrade to various secondary products like Malondialdehyde (MDA) and MDA-like substances which are jointly called Thiobarbituric Acid Reactive Substances (TBARS) which provide meaningful information upon measurements ( 6 ). MDA level is widely utilized as a marker of lipid peroxidation in states of elevated oxidative stress ( 7 ). It is well known that saliva has considerable antioxidant capacity, and lipid peroxidation may happen as a consequence of oxidative stress and impaired capacity of saliva antioxidant power( 8 ). The antioxidant activity may be an important factor providing protection from neuronal damage caused by oxidative stress. Enzymatic and non- enzymatic antioxidants have been proposed as indirect markers, among them: glutathione (GSH), Uric Acid (UA) and Superoxide dismutase (SOD) are related to brain damage and clinical outcome ( 9 ). The diagnostic value of salivary secretions to detect systemic diseases had long been recognized ( 10 ). Salivary assays present a lot of advantages when compared to blood assay: the sampling is very easy to do especially in a non-medical environment. It does not