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Purpose <p>Endoscopic retrograde cholangiopancreatography (ERCP) is widely used in the management of pancreaticobiliary disorders and may be associated with systemic oxidative stress. Dynamic thiol–disulfide homeostasis, which reflects the balance between reduced and oxidized thiol groups, has emerged as a sensitive indicator of systemic redox status. This study aimed to evaluate alterations in thiol–disulfide homeostasis in patients undergoing ERCP.</p> Methods <p>In this observational study, patients undergoing ERCP and control subjects were included. Serum native thiol, total thiol, disulfide levels, and thiol-based ratios were measured using an automated spectrophotometric assay. Baseline demographic and laboratory characteristics were compared between groups. Age-adjusted analyses were performed using analysis of covariance (ANCOVA), and longitudinal changes were evaluated using mixed-effects models.</p> Results <p>Compared with controls, patients undergoing ERCP demonstrated significantly lower native thiol and total thiol levels together with higher disulfide concentrations and altered thiol-based ratios. Age-adjusted analyses confirmed significant group effects for native thiol, total thiol, disulfide, and native thiol/total thiol ratio. Longitudinal analyses showed partial increases in reduced thiol parameters after ERCP; however, post-procedural values remained lower than those observed in controls at the 24-h time point. These alterations were observed irrespective of post-ERCP pancreatitis or pancreatic enzyme elevations.</p> Conclusion <p>Patients undergoing ERCP exhibited significant alterations in thiol–disulfide homeostasis, characterized predominantly by depletion of reduced thiol pools. The observed redox imbalance persisted during the early post-procedural period and appeared to be associated with both underlying pancreaticobiliary disease and procedure-related oxidative stress. Further studies are needed to clarify the clinical significance of these findings.</p>

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Short-Term Alterations in Thiol–Disulfide Homeostasis Following ERCP: A Prospective Controlled Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Mehmet Asıl,
  • Yusuf Avcı,
  • Ali Can Erdem,
  • Ramazan Dertli,
  • Murat Bıyık,
  • Muharrem Keskin,
  • Özcan Erel,
  • Salim Neşelioğlu

摘要

Purpose

Endoscopic retrograde cholangiopancreatography (ERCP) is widely used in the management of pancreaticobiliary disorders and may be associated with systemic oxidative stress. Dynamic thiol–disulfide homeostasis, which reflects the balance between reduced and oxidized thiol groups, has emerged as a sensitive indicator of systemic redox status. This study aimed to evaluate alterations in thiol–disulfide homeostasis in patients undergoing ERCP.

Methods

In this observational study, patients undergoing ERCP and control subjects were included. Serum native thiol, total thiol, disulfide levels, and thiol-based ratios were measured using an automated spectrophotometric assay. Baseline demographic and laboratory characteristics were compared between groups. Age-adjusted analyses were performed using analysis of covariance (ANCOVA), and longitudinal changes were evaluated using mixed-effects models.

Results

Compared with controls, patients undergoing ERCP demonstrated significantly lower native thiol and total thiol levels together with higher disulfide concentrations and altered thiol-based ratios. Age-adjusted analyses confirmed significant group effects for native thiol, total thiol, disulfide, and native thiol/total thiol ratio. Longitudinal analyses showed partial increases in reduced thiol parameters after ERCP; however, post-procedural values remained lower than those observed in controls at the 24-h time point. These alterations were observed irrespective of post-ERCP pancreatitis or pancreatic enzyme elevations.

Conclusion

Patients undergoing ERCP exhibited significant alterations in thiol–disulfide homeostasis, characterized predominantly by depletion of reduced thiol pools. The observed redox imbalance persisted during the early post-procedural period and appeared to be associated with both underlying pancreaticobiliary disease and procedure-related oxidative stress. Further studies are needed to clarify the clinical significance of these findings.