Oxidative Stress and Thiol-disulphide Hemostasis in Children with Anxiety Disorders

Armagan ARAL, Bahattin AVCI , Neriman KESİM, Oğuzhan ŞİMŞEK
2025 September - 62 (3)
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Highlights

• Elevated TOS and OSI levels effectively differentiate
children with AD from HC.
• TOS has been identified as a key biomarker for predicting
AD.
• The alterations in TDH among children with AD were not
statistically significant.


Abstract

Introduction: Anxiety disorders (AD) constitute a significant part of mental health
problems; however, their pathogenesis remains not fully elucidated. The balance
between the oxidative and antioxidative systems are disrupted in children with AD.
The total oxidant/antioxidant status (TOS/TAS) and thiol/disulphide homeostasis
(TDH) show oxidative stress through different mechanisms. To date, research
in this context has tended to focus on adults rather than children. Despite this,
understanding oxidative stress in pediatric populations is increasingly emphasized.
Therefore, this research aims to investigate TOS/TAS and TDH in children with AD.
Methods: The study included 40 treatment-naive children with AD and 40 healthy
controls matched by age and sex. Sociodemographic data and The Screen for Child
Anxiety-Related Emotional Disorders (SCARED) were used for assessment.
Results: The results showed that TOS and the Oxidative Stress Index (OSI) were
elevated, and TAS was reduced in children with AD compared to controls.
However, when evaluated in terms of TDH, there was no significant difference.
Logistic regression analysis identified TOS as a significant predictor of AD (p=0.027;
OR=5.49, 95% CI: 1.21–24.84). Although dynamic-disulphide level improved the
model’s predictive accuracy, they did not reach statistical significance (p=0.063).
Conclusion: These findings suggest a potential oxidative dysfunction in AD. The
study highlights the potential utility of TOS as a robust biomarker for distinguishing
pediatric AD from HC. Furthermore, the absence of significant changes in TDH
suggests that oxidative stress in pediatric AD may primarily involve alternative
pathways. This may involve a complex interplay of DNA damage, lipid peroxidation,
and protein oxidation processes contributing to the oxidative stress observed in
AD. To explore the potential for using oxidative stress markers as novel targets for
treatment and diagnostic tools for AD, prospective, large-scale, randomized trials
are required.
Keywords: Anxiety disorders, child, oxidative stress, thiol/disulphide hemostasis