The effect of superoxide dismutase on lipid peroxidation products and antioxidant activity in peritoneal exudate in the terminal phase of peritonitis

Rana Karimova; Firangiz  Guliyeva; Afag  Kazimova; Elchin  Akbarov; Sevinj  Maharramova; Yegana  Shakaraliyeva; Leyla  Baghirova; Aygun  Aliyarbayova; Mahabbat  Fataliyeva; Natavan  Khidirova; Ulviyya  Ahmadzada; Mehriban  Kazimova; Huseyn  Abiyev; Orkhan  Isayev

doi:10.23750/abm.2026.19045

Authors

Rana Karimova Department of Modeling of Pathological Processes, Experimental Surgery and Therapy, Scientific Research Center, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0009-0004-4323-9625
Firangiz Guliyeva Department of Biochemistry, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0002-2206-1803
Afag Kazimova Department of Pharmacology, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0003-3358-6709
Elchin Akbarov Department of Pathology, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0001-8721-4519
Sevinj Maharramova Department of Pharmacology, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0002-1131-2005
Yegana Shakaraliyeva Department of Medical Biology and Genetics, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0002-0653-7605
Leyla Baghirova Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan https://orcid,org/0009-0008-9633-1264
Aygun Aliyarbayova Department of Cytology, Embryology and Histology, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0003-0887-3132
Mahabbat Fataliyeva Department of Family Medicine, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0002-0255-9719
Natavan Khidirova I Department of Surgical Diseases, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0003-0451-0908
Ulviyya Ahmadzada Department of Pathological Physiology, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0009-0007-9120-8083
Mehriban Kazimova Department of Normal Physiology, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0009-0006-3567-7953
Huseyn Abiyev Department of Medical and Biological Physics, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0009-0004-9319-5317
Orkhan Isayev Director of the Scientific Research Center, Azerbaijan Medical University, Baku, Azerbaijan https://orcid.org/0000-0002-9673-7458

Keywords:

terminal peritonitis, peritoneal exudate, lipid peroxidation, superoxide dismutase, antioxidant activity, adjunctive therapy

Abstract

Background and aim: Peritonitis is a common and clinically significant disease of the abdominal cavity. In the terminal stage of the disease, increased oxidative stress leads to the intensification of lipid peroxidation processes and impairment of the antioxidant defense system. The aim of this study was to evaluate the levels of lipid peroxidation products in peritoneal exudate obtained from patients with terminal peritonitis and to investigate the effect of superoxide dismutase (SOD) on these parameters under ex vivo conditions.

Methods: The study included 30 patients (17 males and 13 females; age range 34–72 years) diagnosed with terminal peritonitis who received standard clinical management. Peritoneal exudate samples obtained during surgery were divided into aliquots under ex vivo conditions and incubated at 10°C for 6 and 24 hours with and without the addition of superoxide dismutase (SOD). Analyses were performed within each sample using a paired design. Malondialdehyde (MDA), diene conjugates (DC), and total antioxidant activity (TAA) were measured in the peritoneal exudate.

Results: At baseline, MDA and DC levels were 2.98 ± 0.08 nmol/mL and 2.56 ± 0.14 nmol/mL, respectively, while total antioxidant activity was 21.09 ± 0.57. After 24 hours of incubation with SOD, MDA and DC levels significantly decreased, whereas total antioxidant activity significantly increased (p < 0.001).

Conclusions: These findings highlight the potential therapeutic relevance of antioxidant approaches aimed at reducing oxidative stress in peritonitis.

References

1. Camargo CH, de Souza da Cunha MLR, Caramori JCT, Mondelli AL, Montelli AC, Barretti P. Incidence and characteristics of methicillin-resistant coagulase-negative Staphylococcus aureus in peritoneal dialysis-associated peritonitis in a single center using molecular methods. Int Urol Nephrol. 2021 Feb;53(2):373-380. doi: 10.1007/s11255-020-02605-9. Epub 2020 Aug 17. Erratum in: Int Urol Nephrol. 2021 Feb;53(2):381. doi: 10.1007/s11255-020-02662-0.

2. Freitas M, Calice Silva V. Fungal peritoneal dialysis-associated peritonitis as a silent threat: the critical role of early diagnosis and catheter removal. Cureus. 2024;16(12):e76191. doi: 10.7759/cureus.76191

3. Juarez Villa D, Cano Escobar KB, Toledo Ramirez S, Zepeda Quiroz I. Fungal peritonitis associated with peritoneal dialysis due to non-albicans candida: a case series. Cureus. 2022;14(12):e32658. doi: 10.7759/cureus.32658

4. Lin Y, Alhaskawi A, Chen L, Moqbel SAA. Recent advances in understanding oxidative stress in sepsis: pathogenic roles and antioxidant therapeutic prospects – a narrative review. Front Pharmacol. 2025;16:1695992. doi: 10.3389/fphar.2025.1695992

5. Javed A, Mehboob K, Rashid A, Majid A, Khan S, Baig ZA. Oxidative stress and lipid peroxidation in NAFLD with and without type 2 diabetes mellitus. J Coll Physicians Surg Pak. 2023;33(11):1254-8. doi: 10.29271/jcpsp.2023.11.1254

6. Valgimigli L. Lipid peroxidation and antioxidant protection. Biomolecules. 2023;13(9):1291. doi: 10.3390/biom13091291

7. Foret MK, Lincoln R, Do Carmo S, Cuello AC, Cosa G. Connecting the “dots”: from free radical lipid autoxidation to cell pathology and disease. Chem Rev. 2020;120(23):12757-87. doi: 10.1021/acs.chemrev.0c00761

8. Gęgotek A, Skrzydlewska A. Biological effect of protein modifications by lipid peroxidation products. Chem Phys Lipids. 2019;221:46-52. doi: 10.1016/j.chemphyslip.2019.03.011

9. von Krusenstiern AN, Robson RN, Qian N, et al. Identification of essential sites of lipid peroxidation in ferroptosis. Nat Chem Biol. 2023;19(6):719-30. doi: 10.1038/s41589-022-01249-3

10. Ursini F, Maiorino M. Lipid peroxidation and ferroptosis: the role of GSH and GPx4. Free Radic Biol Med. 2020;152:175-85. doi: 10.1016/j.freeradbiomed.2020.02.027

11. Ito F, Sono Y, Ito T. Measurement and clinical significance of lipid peroxidation as a biomarker of oxidative stress: oxidative stress in diabetes, atherosclerosis, and chronic inflammation. Antioxidants (Basel). 2019;8(3):72. doi: 10.3390/antiox8030072

12. Tsikas D. Assessment of lipid peroxidation by measuring malondialdehyde (MDA) and relatives in biological samples: analytical and biological challenges. Anal Biochem. 2017;524:13-30. doi: 10.1016/j.ab.2016.10.021

13. Dalbaşı E, Gedik E, Tüzün A, Obay BD. Correlation of malondialdehyde and antioxidant enzyme levels with peritonitis severity in patients with generalized peritonitis. Dicle Med J. 2020;47(2):293-303. doi: 10.5798/dicletip.755706

14. Chaudhary P, Janmeda P, Docea AO, et al. Oxidative stress, free radicals and antioxidants: potential crosstalk in the pathophysiology of human diseases. Front Chem. 2023;11:1158198. doi: 10.3389/fchem.2023.1158198

15. Jomova K, Raptova R, Alomar SY, et al. Reactive oxygen species, toxicity, oxidative stress, and antioxidants: chronic diseases and aging. Arch Toxicol. 2023;97(10):2499-2574. doi: 10.1007/s00204-023-03562-9

16. Fakhri S, Abbaszadeh F, Moradi SZ, et al. Effects of polyphenols on oxidative stress, inflammation, and interconnected pathways during spinal cord injury. Oxid Med Cell Longev. 2022;2022:8100195. doi: 10.1155/2022/8100195

17. Duni A, Liakopoulos V, Roumeliotis S, Peschos D, Dounousi E. Oxidative stress in the pathogenesis and evolution of chronic kidney disease: untangling Ariadne’s thread. Int J Mol Sci. 2019;20(15):3711. doi: 10.3390/ijms20153711

18. Chen L, Liu Y, Zhang Y, et al. Superoxide dismutase ameliorates oxidative stress and regulates liver transcriptomics to provide therapeutic benefits in hepatic inflammation. PeerJ. 2023;11:e15829. doi: 10.7717/peerj.15829

19. Olivares-Vicente M, Herranz-Lopez M. The interplay between oxidative stress and lipid composition in obesity-induced inflammation: antioxidants as therapeutic agents in metabolic diseases. Int J Mol Sci. 2025;26(17):8544. doi: 10.3390/ijms26178544

20. Ávila-Escalante ML, Coop-Gamas F, Cervantes-Rodríguez M, Méndez-Iturbide D, Aranda-González II. The effect of diet on oxidative stress and metabolic diseases—clinically controlled trials. J Food Biochem. 2020;44(5):e13191. doi: 10.1111/jfbc.13191

21. Islam MN, Rauf A, Fahad FI, et al. Superoxide dismutase: an updated review on its health benefits and industrial applications. Crit Rev Food Sci Nutr. 2022;62(26):7282-300. doi: 10.1080/10408398.2021.1913400

22. Karimova R, Polukhova S, Gasimova G, et al. The effect of superoxide dismutase on protein exchange indicators in peritoneal exudate in the terminal phase of peritonitis. Acta Biomed. 2026;97(1):18026. doi: 10.23750/abm.2026.18026