Table 1.
Main points to be considered in oxidative stress related assessment and result interpretation.
| Steps in OxS Assesment | Main Points and Advices |
|---|---|
| Biomarker selection | select the most possible adequate analyte/s (single versus panel) for the population/setting investigated |
| consider distribution volume/metabolism/clearance of the biomarker/s | |
| Test selection | select the best assay/method for the population/setting investigated |
| Population | select the appropriate population (general population, patients) according to: |
| clinical setting (screening, diagnosis, prognosis, monitoring, treatment) | |
| athophysiology (diseases risk, diagnosis, stage) | |
| Sample collection | select biological sample (e.g., blood, urine, saliva) |
| select anticoagulant and addition of stabilizers | |
| consider subject posture | |
| consider circadian rhythm (withdrawal time) | |
| fasting status | |
| Sample transport and processin | sample handling (prompt transport, temperature, time) |
| centrifugation modalities (rpm, temperature) | |
| prompt aliquot preparation for tests non immediately assayed | |
| Sample storage | at −20 °C, best −80 °C |
| avoid freeze-thaw cycles | |
| consider possible sample alterations with long storage time | |
| Sample testing | evaluate additional steps (e.g., deproteinization, extraction/derivatization) |
| assay specificity/sensibility | |
| evaluate presence of hemolysis, high lipid content | |
| consider assay/method agreement | |
| select “one spot” versus serial assessment | |
| Result interpretation | availability of reference values/cut-off |
| knowledge of assay/method limitations | |
| knowledge of variability due to additive determinants (e.g., genetic, physiological factors, lifestyle, intra/inter variability) | |
| awareness of different measurement units that can complicate result interpretation | |
| Antioxidant supplementation | antioxidant dose |
| antioxidant type | |
| single versus multi-antioxidant approach | |
| supplementation time | |
| interaction/synergism between antioxidant | |
| interference of dietary antioxidants | |
| higher requirement of vitamin intake (e.g., smokers, inactive people, etc) | |
| supplementation able to give a sufficient blood concentration to be effective | |
| avoid too high concentration, to exclude possible pro-oxidant effects | |
| initiation time according to the stage of disease (is antioxidant supplementation more effective to reverse mild damage?) | |
| redox homeostasis as target of supplementation | |
| selection of subjects/patients with increased oxidative stress to be supplemented | |
| Antioxidant drugs | drugs that selectively target oxidative stress pathways increasing ROS production and cancer cellular death |
| common drugs with antioxidant properties (e.g., statins, B-blockers, ACE-inhibitors, ARB in the cardiovascular field) | |
| also potentially effective for other disease prevention/treatment | |
| epigenetic miRNA-based approaches |