The understanding of the importance of oxidant/antioxidant status in hemophilia patients with arthropathy

This study aimed to investigate the roles of pro-inflammatory cytokine [interleukin-1β (IL-1β)], receptor activator of nuclear factor-kappa B ligand (RANKL), prooxidant [reactive oxygen species (ROS), thiobarbituric acid reactive sub stances (TBARS), advanced oxidation protein products (AOPP), advanced glycation end-products (AGEs)], and antioxi dant markers [ferric reducing antioxidant power (FRAP), total-thiol content (t-SH)] in the pathogenesis of arthropathy in patients with hemophilia (PwH) with/without arthropathy, and to identify potential therapeutic targets for preventing arthropathy and improving quality of life. The study included 18 PwH without arthropathy [31.0 years; (13–65)] and 39 PwH with arthropathy [10 years; (3–36)]. Among PwH with arthropathy, 6% were inhibitor positive, and 26.3% had involvement of more than two joints. Serum ROS and AGE were measured by fluorometric method, while TBARS, AOPP, FRAP, and t-SH were assessed via spectrophotometrically. IL-1β and RANKL concentrations were determined using ELISA. AGE and RANKL concentrations were significantly higher in PwH with arthropathy compared to those without (p=0.002 and p=0.010, respectively), and differences remained significant after age adjustment. FRAP and t-SH levels were initially elevated in PwH with arthropathy (p=0.030 and p=0.007, respectively), but differences lost significance after age adjustment. No significant differences were observed in ROS, TBARS, AOPP, or IL-1β levels between groups. Elevated AGE and RANKL levels in PwH with arthropathy suggest their potential involvement in joint damage and highlight the importance of maintaining oxidant/antioxidant balance. Therefore, monitoring these biomarkers may provide supportive information for early detection and inform future research on preventive strategies to reduce joint complications and preserve long-term quality of life in hemophilia.