Evaluation of oxidative stress in patients with recalcitrant warts

J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1952-1957. doi: 10.1111/jdv.15746. Epub 2019 Jul 3.


Background: Warts are benign conditions of the skin and mucosa caused by human papilloma viruses (HPV) that affect many people worldwide.

Objective: The aim of this study was to evaluate OS by TOS/TAS, levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) an indicator of DNA damage, and also protein oxidation levels by determining the dynamic serum thiol/disulphide homeostasis in patients with warts. We also aimed to investigate whether there is a relationship between thiol/disulphide homeostasis, recalcitrance of warts and DNA damage.

Methods: Forty patients of age ≥18 years, having recalcitrant genital and/or non-genital warts that persisted for more than 2 years, 40 patients with warts that persisted for <2 years and 40 healthy controls were enrolled in the study. Blood TAS, TOS, OSI, 8-OHdG and dynamic thiol/disulphide homeostasis were evaluated.

Results: Significant differences were detected between the groups in the levels of 8-OHdG, TOS, OSI, total thiol, native thiol, reduced thiol, as well as native thiol/total thiol ratio, disulphide/total thiol ratio and disulphide/native thiol ratio. Compared with the controls, patients with recalcitrant warts had significantly higher levels of 8-OHdG, TOS and OSI levels. Total thiol and native thiol levels were significantly lower in patients with recalcitrant warts compared with patients with warts that persisted for <2 years. Disulphide levels were significantly higher in the latter group of patients compared with patients with recalcitrant warts and controls. Native thiol/total thiol ratio was significantly higher in both patient groups compared with controls whereas disulphide/total thiol and disulphide/native thiol ratios were significantly lower in both patient groups than in controls.

Conclusion: Our findings suggest that impairment of thiol disulphide homeostasis in patients with recalcitrant warts may lead to increased OS and DNA damage. Thus, antioxidant administration with thiol containing proteins may help in the regression of warts and thereby prevent carcinogenesis.

MeSH terms

  • 8-Hydroxy-2'-Deoxyguanosine / blood
  • Adolescent
  • Adult
  • Antioxidants / metabolism
  • Chronic Disease
  • DNA Damage*
  • Disulfides / blood
  • Female
  • Homeostasis*
  • Humans
  • Male
  • Middle Aged
  • Oxidants / blood
  • Oxidative Stress*
  • Sulfhydryl Compounds / blood
  • Warts / blood
  • Warts / physiopathology*
  • Young Adult


  • Antioxidants
  • Disulfides
  • Oxidants
  • Sulfhydryl Compounds
  • 8-Hydroxy-2'-Deoxyguanosine