Oxidative/nitrosative stress, a pervasive condition of increased amounts of reactive oxygen/nitrogen species, is now recognized to be a prominent feature of many acute and chronic diseases and even of the normal aging process. However, definitive evidence for this association has often been lacking because of recognized shortcomings with biomarkers and/or methods available to assess oxidative stress status in humans. Emphasis is now being placed on biomarkers of oxidative stress, which are objectively measured and evaluated as indicators of normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic intervention. To be a predictor of disease, a biomarker must be validated. Validation criteria include intrinsic qualities such as specificity, sensitivity, degree of inter- and intraindividual variability, and knowledge of the confounding and modifying factors. In addition, characteristics of the sampling and analytical procedures are of relevance, including constraints and noninvasiveness of sampling, stability of potential biomarkers, and the simplicity, sensitivity, specificity, and speed of the analytical method. Here we discuss some of the more commonly used biomarkers of oxidative/nitrosative damage and include selected examples of human studies.

Oxidative stress has been related increasingly to the onset and/or progression of a growing number of human diseases. However, large studies on supplementation with anti-oxidants for prevention or treatment of different pathologies have yielded contradictory and mostly negative results, as documented by numerous meta-analyses and clinical trials. Here we analyze in detail the findings of these studies and discuss major aspects that, in our opinion, are likely to be responsible for these confounding data. With the belief that a clear correlation between disease and oxidative stress is far from being proven for most pathological conditions, our argument focuses on the following points: i) choice of biomarker(s) and/or the biological system(s) for the analyses; ii) pitfalls in pre-analytical and analytical methods for assessing oxidative stress; and iii) scientific misconduct. Eventually, suggestions aiming to obtain more convergent results on this topic are provided.