1. Free radicals and thermal water- controlled pilot study T Bender,G Nagy,J Bariska,R Vághy,R Gomez,I Kovács

3.  Free radicals play an important role in a number of biological processes, some of which are necessary for life, such as the intracellular killing of bacteria by neutrophil granulocytes.  Free radicals have also been implicated in certain cell signaling processes. The two most important oxygen- centered free radicals are superoxide and hydroxyl radical.  They are derived from molecular oxygen under reducing conditions. However, because of their reactivity, these same free radicals can participate in unwanted side reactions resulting in cell damage.

4.  Many forms of cancer are thought to be the result of reactions between free radicals and DNA, resulting in mutations that can adversely affect the cell cycle and potentially lead to malignancy.

5.  Because free radicals are necessary for life, the body has a number of mechanisms to minimize free radical induced damage and to repair damage which does occur, such as the enzymes superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase. enzymessuperoxide dismutase catalaseglutathione peroxidaseenzymessuperoxide dismutase catalaseglutathione peroxidase

6.  Antioxidant means "against oxidation." Antioxidants work to protect lipids from peroxidation by radicals. Antioxidants are effective because they are willing to give up their own electrons to free radicals. When a free radical gains the electron from an antioxidant it no longer needs to attack the cell and the chain reaction of oxidation is broken  After donating an electron an antioxidant becomes a free radical by definition. Antioxidants in this state are not harmful because they have the ability to accommodate the change in electrons without becoming reactive.

7.  The human body has an elaborate antioxidant defense system. Antioxidants are manufactured within the body and can also be extracted from the food humans eat such as fruits, vegetables, seeds, nuts, meats, and oil. There are two lines of antioxidant defense within the cell.

9.  The Aim of our study:  Does the free radicals change before and after Balneotherapy?  Is there any change in case of using tap water?

10.  Cserkeszölő:(3658mg)  Kation(Natrium-Kalium 1100mg,Ca 18,6mg(altogether:1145mg)  Anion:Cl 985,Br: 12,5 Jodide: 1,2  HCO:1342,altogether: (2344mg)  Mórahalom:  Kation:Natrium 520,altogether:532  Fluorid 1,3, HCO3 1:300mg  Altogether:(1949mg)

11.  Method  Patients:N:30(10 in each group)  Dg: Spondylosis lumbalis  They got no NSAID and steroids,no other disease  Duration of the bath 30 minutes T:34 C  Blood samples were taken before the first bath, after the first bath and at end of 10 baths  Examination: MDA protein, a Glutathion peroxidase, Catalase,and Superoxid dismutase level  Method HCLP

12. Results: after the 10. treatments

13.  Explanation:  There is difference between tap water  and mineral water concerning on the free radicals  The two changes during tap water maybe due to the thermal effect

14. Literatures:  Twenty-eight patients (19 female, 9 male) primary osteoarthritis  Bursa Military Hospital (Spa group) Spa group patients had 10 –15 minute head out immersion in 39-41 C thermomineral water, physical therapy and regular exercise for 15 days  Control patients home exercise and simple analgesics  Prof Negris Erdogan the effect of spa therapy on plsama MDA and TAA system(II Hungarian- Turkish Baln. meeting)

15.  Plasma malondialdehit (MDA) and total antioxidant capacity (TAA) were compared. Seven patients (5 male, 2 female) İstanbul Medical Faculty Medical Ecology Hydroclimatology department ambulatory policlinic (Control group)   Oxidant effect of hyperthermic baths and antioxidant consumption in defence to oxidative stress.Disappearance of inverse proportion between disease duration and MDA level  Balneotherapy more effective in early period of disease in decreasing oxidative stress?! Spa therapy decreases oxidant stress ?!Increases TAA levels in male and Decreases in females (menopause-estrogens deficiency?)  )Decrease in oxidant stress is more prominent.Increase of antioxidant defence is less manifest  Prof Negris Erdogan the effect of spa therapy on plsama MDA and TAA system(II Hungarian- Turkish Baln. meeting)

16.  They enrolled 37 subjects and randomly assigned them to two groups: 19 patients underwent mud bath treatment (group A) while 18 patients underwent bath treatment alone. Blood samples were obtained before and after the treatment cycles to assay serum levels of NO, myeloperoxidase (MPO) and glutathione (GSH)-peroxidase.  Bellometti S, Poletto M, Gregotti C, Richelmi P, Berte F. Int J Clin Pharmacol Res. 2000;20(3-4):69-80. Bellometti SPoletto MGregotti CRichelmi PBerte F Bellometti SPoletto MGregotti CRichelmi PBerte F 

17.  The results showed a statistically significant decrease in NO and myeloperoxidase serum values in groups A and B, while GSH-peroxidase was not significantly increase in either of the groups; no correlation was found between NO, myeloperoxidase and GSH-peroxidase serum values. Mud bath treatment can exert beneficial effects on cartilage homeostasis and inflammatory reactions, influencing NO and decreasing myeloperoxidase serum values.  Bellometti S, Poletto M, Gregotti C, Richelmi P, Berte F. Int J Clin Pharmacol Res. 2000;20(3-4):69-8 Bellometti SPoletto MGregotti CRichelmi PBerte F Bellometti SPoletto MGregotti CRichelmi PBerte F .

18.  The increase in GSH-peroxidase was not correlated with the reduction of other biochemical markers, suggesting that mud bath treatment has different mechanisms of action. Mud bath therapy influences nitric oxide, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients. Bellometti S, Poletto M, Gregotti C, Richelmi P, Berte F. Int J Clin Pharmacol Res. 2000;20(3-4):69-80. Bellometti SPoletto MGregotti CRichelmi PBerte F Bellometti SPoletto MGregotti CRichelmi PBerte F

19.  This study therefore sought to investigate the effect of 3-week therapy with sulfur baths on antioxidative defense systems, peroxide concentrations, and lipid levels in patients with degenerative osteoarthritis A 17.2% decline in peroxide concentrations (p = 0.10, n.s.) and significant lower SOD activities (p < 0.001) were detected in the sulfur group at the end of the therapy.  Ekmekcioglu C, Strauss-Blasche G, Holzer F, Marktl W. Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20. Ekmekcioglu CStrauss-Blasche GHolzer FMarktl W Ekmekcioglu CStrauss-Blasche GHolzer FMarktl W

20.  Until the end of therapy total cholesterol levels changed differentially (p = 0.007) in the sulfur group (from 229.11 +/- 34.47 mg/dl to 217.46 +/- 40.45 mg/dl) and in the control group (from 197.63 +/- 34.66 mg/dl to 207.95 +/- 33.02 mg/dl).  Ekmekcioglu C, Strauss-Blasche G, Holzer F, Marktl W. Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20. Ekmekcioglu CStrauss-Blasche GHolzer FMarktl W Ekmekcioglu CStrauss-Blasche GHolzer FMarktl W

21.  A similar significant group difference was found for LDL (p = 0.017), with a 5.9% reduction in the sulfur group and a 6.1% increase in the control group. CONCLUSIONS: The results presented here suggest that a sulfur bath therapy could cause a reduction in oxidative stress, alterations of SOD activities, and a tendency towards improvement of lipid levels..  Ekmekcioglu C, Strauss-Blasche G, Holzer F, Marktl W. Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):216-20. Ekmekcioglu CStrauss-Blasche GHolzer FMarktl W Ekmekcioglu CStrauss-Blasche GHolzer FMarktl W

22.  Conclusion:  The measurement of free radicals gives valuable informations about the possible mechanism of balneotherapy and furthers studies need to clarify this topic