Description
Normal metabolic processes generate potentially deleterious reactive oxygen species, oxidative damage and inflammation, which increase with age and may contribute to senescence. Oxidative stress and inflammation have been implicated in many heart, lung, blood, and sleep (HLBS) disorders, including atherosclerosis, hypertension, asthma, COPD, acute lung injury, heart failure and sleep apnea. CRP and other measures of inflammation have been incorporated into many population studies. However, there are many components to these complex systems and it is unclear which are the most predictive of disease, and how these measures can be integrated with measures of oxidative stress. Both oxidative stress and inflammation biomarkers, as well as anti-oxidants and anti-inflammatory factors, need to be measured concurrently since the metabolic processes overlap and the lack of balance between these stressors and protectors may lead to development or progression of HLBS disorders. While there are many biomarkers of inflammation, oxidative stress is difficult to measure in vivo. Reliable surrogate biomarkers for use in large-scale population studies need to be identified. The NHLBI thus convened a workshop on August 18-19, 2004 with the following objectives: 1) assess the opportunities for incorporating measures of oxidative stress and inflammation into population studies; and 2) recommend future research directions for studying the role of these risk factors in the development of HLBS disorders.
The workshop began with recognition of the importance of studying oxidative stress in population studies despite the failure of antioxidant trials, and an overview of criteria to be considered in selecting biomarkers for population studies. Laboratory/clinical perspectives on several biomarkers and/or methods were next presented, followed by the experience to date in utilizing these biomarkers in several NHLBI observational studies and clinical trials. Integrating oxidative stress and inflammation biomarkers and methodological issues were also addressed. The workshop concluded with summary and recommendations on which biomarkers were currently suited for use in large scale population studies, and what additional data and/or resources were needed to continue work in this field.