Ampio

What is ORP?
Oxidation-reduction potential (ORP) is a measure of the tendency of a chemical species to acquire electrons and thereby be reduced. Reduction potential is measured in volts (V), millivolts (mV), or Eh (1 Eh = 1 mV). Each chemical species has its own intrinsic reduction potential; the more positive the potential, the greater the species’ affinity for electrons and tendency to be reduced.

Under normal physiological conditions, many enzymatic reactions are oxidation-reduction reactions in which one compound is oxidized and another compound is reduced. The ability of an organism to carry out these critical oxidation-reduction reactions depends on the oxidation-reduction state of the environment, or its reduction potential (ORP). Much like temperature, pH, glucose level, oxygen concentration, etc., the body tightly controls the range of this potential in order to be compatible with life, and as such ORP is a homeostatic parameter. Reducing agents are referred to as antioxidants while oxidizing agents, which include free radicals and certain transition metals, are referred to as oxidants. Antioxidants include low molecular weight molecules such as free sulfhydryl-containing molecules, vitamins such as Vitamin A, C, & E, flavinoids, and uric acid to name a few. In healthy individuals, the amount of reductants (antioxidants) exceeds the oxidants thereby imparting continuous protection from the constant production and/or exposure to oxidants. The sources of antioxidants include diet, de novo synthesis, and/or regeneration by an enzymatic reaction. The introduction of high levels of oxidants is referred to as “oxidative stress” and can be induced by a variety of conditions.

Illness and ORP
In the critically ill, the presence of oxidative stress is well documented. In these patients, oxidative stress occurs as a direct result of the amount of inflammation. During an inflammatory process, free radicals are produced by the immune system at higher rates at the inflammation site. The amount of free radicals produced depends on the severity of the insult. If the amount overwhelms a patient’s antioxidant capacity, then free radical damage to vital cellular components such as lipids, DNA, and proteins can occur.

Challenges in Assessing Oxidant / Antioxidant Balance in Biological Fluids
Measuring multiple biochemical parameters, such as total antioxidants, lipid peroxidation, free radical production, protein oxidation, and enzyme activity, is complex, time consuming and impractical for the clinical setting. More importantly, these types of analyses are likely to miss other contributing factors to the overall redox balance in a trauma patient. In preliminary studies, Ampio has clearly demonstrated increases in plasma ORP in multi-trauma patients during the first few days of hospitalization compared to controls¹. In these patients, ORP levels approached normal ORP levels upon discharge. Additionally, Ampio has shown that ORP values correlate proportionately with the severity of traumatic brain injury², oxidation of stored blood products over time³, and the viability of an organ prior to transplant⁴. Ampio’s proprietary ORP technology rapidly measures plasma ORP in real time with a hand-held, point-of-care device suitable for all clinical settings.

Clinical Studies
Ampio is conducting clinical trials iincluding a stroke study, a PET/CT/ORP study in chest pain patients, evaluation of lactate and ORP by paramedical personnel and ORP in critically-ill, older traumatized patients. Results of these trials, which are anticipated to be completed within the coming months, will determine the clinical utility of Ampio’s point-of-care ORP device.

1 Rael, L.T., Bar-Or, R., Aumann, R.M., Slone, D.S., Mains, C.W., and Bar-Or, D. (2007). Oxidation-reduction potential and paraoxonase-arylesterase activity in trauma patients. Biochem Biophys Res Commun 361, 561-565.
2 Rael, L.T., Bar-Or, R., Mains, C.W., Slone, D.S., and Bar-Or, D. (2009). Plasma oxidation-reduction potential and protein oxidation in traumatic brain injury. J Neurotrauma 26(8):1203-11.
3 Rael, L.T., Bar-Or, R., Ambruso, D.R., Mains, C.W., Slone, D.S., Craun, M.L., and Bar-Or, D. (2009). The effect of storage on the accumulation of oxidative biomarkers in donated packed red blood cells. J Trauma 66, 76-81.
4 Bar-Or, R., Rael, L.T., Curtis, C.G., Mains, C.W., Slone, D.S., and Bar-Or, D. (2009). Raman spectral signatures of human liver perfusates correlate with oxidation reduction potential. Mol Med Reports 2, 175-180.

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