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Oxidative stress results from the generation and overaccumulation of reactive oxygen and nitrogen species and has been shown to damage lipoproteins, lipids, DNA, and proteins. Furthermore, oxidative stress may modulate modifications to these lipoproteins and DNA such that endothelial function and inflammatory processes are altered, ultimately resulting in the initiation and progression of atherosclerosis and cardiovascular disease (CVD). Isoprostanes are a series of prostaglandin-like compounds produced via the free-radical catalyzed peroxidation of arachidonic acid, independent of the cyclooxygenase-derived prostaglandins. F2-isoprostanes are considered the "gold standard" test for quantifying lipid peroxidation/oxidative stress in vivo. 15-F2t-isoprostane (15-F2t-IsoP), also referred to as 8-iso-PGF2 alpha or 8-isoprostane F2 alpha, is 1 of the F2-isoprostanes produced in abundance in vivo and has demonstrated potency as a vasoconstrictor within the vasculature of the heart, brain, lung, and kidneys. Generation of 15-F2t-IsoP induces downstream effects including proliferation of vascular smooth muscle cells and release of endothelin. Additional evidence suggests that F2-isoprostanes may increase aspirin resistance to platelet aggregation within platelets and whole blood.
F2-isoprostanes are advantageous over other markers of lipid peroxidation due to their in vivo and in vitro stability and are detectable in a variety of human tissues and biological fluids including plasma, urine, lavage fluid, RBCs, and cerebrospinal fluid. Quantitation of F2-isoprostanes in a random urine specimen is considered to be the most accurate and robust measurement of circulating isoprostanes and is a noninvasive method of assessment.
The assessment of in vivo lipid peroxidation and considered to be an index of systemic oxidative stress over time
Elevated urinary F2-isoprostanes reflect widespread oxidative stress and systemic burden of lipid peroxidation end products. Quantitation of F2-isoprostanes in urine is highly dependent upon the methodology utilized; however, mass spectrometry methods (gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry) assays yield superior sensitivity and analytical specificity compared with immunoassays.
F2-isoprostanes demonstrate superior clinical sensitivity compared to other oxidative stress biomarkers but lack clinical specificity for any particular disease. Pharmacological treatment with antioxidant supplementation, hypoglycemic agents in diabetes, smoking cessation, and weight reduction have all been shown to decrease production of F2-isoprostanes.
For the most accurate assessment of lipid oxidation status, individuals should not be on aspirin or other nonsteroidal anti-inflammatory drugs, have smoked, or have had acute changes in statin mono- or combination therapies.
> or =18 years: < or =1.0 ng/mg creatinine
<18 years: not established
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