Supervisors info:
Ιωάννα Ανδρεάδου Επίκ. Καθηγήτρια (Επιβλέπουσα), Σοφία Μαρκαντώνη - Κυρούδη, Καθηγήτρια, Ευάγγελος Καραλής Λέκτορας
Summary:
Introduction: Smoking is presented as an independent and aggravating health
factor, especially for the cardiovascular system through oxidative stress and
endothelial dysfunction. Nicotine dependence is the main cause of quitting
incapability. Worldwide, three medications constitute the pillar of smoking
cessation assistance: varenicline, nicotine replacement (NRT) and bupropion.
Purpose: In this study we investigated and compared the effect of the two main
medication lines (varenicline and NRT) on biological markers of oxidative
stress, plasma level of thiosulfates and angiology parameters. Materials and
Methods: Extensive patient's case history and plasma samples were obtained from
189 active smokers who were previously divided into three groups: 1. in
patients who ceased smoking 2. in those who reduced smoking by 50% 3. in
patients who didn’t alter their smoking habit. Also, patients were divided
according to the received medication line: varenicline (n=70, 37%), NRT (n=96,
51%), no treatment (n=23, 12%). We measured the plasma levels of MDA, PCs and
S2O3-2, the exhaled CO and as vascular indicators we measured the aortic PWV
and microvascular PBR. Results: In all the patients who ceased smoking we
observed a reduction in the exhaled CO regardless of treatment (p0,05), while
no change was observed in the other hemodynamic data. Patients who stopped
smoking and were treated with varenicline have demonstrated reduced levels of
MDA and PCs along with increasing levels of thiosulphates in the first 3 months
of treatment (p0,05). The same trend was also observed in patients on NRT but
after 6 months of treatment (p0,05), while in this patient group no change in
thiosulphates levels was observed. However, no change was observed in the
oxidative stress levels in the other patient groups. Noted that, only in
patients treated with varenicline there is a correlation between the MDA, the
PCs and exhaled CO in the first and third month of treatment. Finally, in
comparison varenicline seems to excel against NRTs in reducing oxidative stress
in the third month of treatment (p0,05). Conclusion: Varenicline and NRT
induce an antioxidant activity in patients who quit smoking in the third and
sixth month of treatment, respectively, and protect against the increase of
oxidative stress in the first trimester in patients who have reduced smoking by
50%. Varenicline seems to reduce levels of ox. Stress more than the NRTs
treatment. Only varenicline, among the other medications, increases
thiosulphates plasma levels in patients who reduce smoking during the third
month of treatment.
Keywords:
Oxidative Stress, Smoking Cessation, Varenicline, Nicotine Replacememnt Therapy, Thiosulfates anions
