Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 5, August, p. 789–793
Publication type: original article
Total antioxidant capacity in Mediterranean β-thalassemic patients
1 Department of Medicine, Section of Internal Medicine, University of Verona, Italy
2 Department of Biomedical Sciences, University of Sassari, Italy
3 Department of Medical Laboratories, Alexander Technological Educational Institute of Thessaloniki, Sindos, Greece
4 Saint Paul General Hospital, Thessaloniki, Greece
5 Blood Center, Servizio Trasfusionale, Ospedale Santissima Annunziata, Sassari, Italy
6 Department of Oncology, University of Turin Medical School, Turin, Italy
7 Department of Electrical Engineering and Electronics, University of Cagliari, Italy
Background. Beta thalassemia major (BT) is an inherited blood disorder caused by reduced or absent synthesis of the hemoglobin beta chains, associated with profound anemia, jaundice, splenomegaly, expanded bone marrow volume, siderosis and cardiomegaly. Because of repeated blood transfusions, BT patients are subjected to peroxidative tissue injury due to secondary iron overload.
Objectives. The aim of the study was to analyze: 1) the total antioxidant capacity (TAC) value in BT patients (study group) and their healthy controls (control group) from Greece (Central Macedonia) and Italy (Sardinia); correlations between 2) the TAC and ferritin levels of BT patients, and 3) the TAC and ferritin values in BT patients with different chelation therapies;
Material and Methods. The studied group consisted of 60 subjects diagnosed with BT (41 female, mean age: 41.5 ± 9.5 years) and 40 healthy controls matched with age and sex (31 female, mean age: 38.5 ± 3.7 years). Desferrioxamine (DFO) was the basic previous chelation regimen for all BT patients. Antioxidant activity was assayed spectrophotometrically, using a TAC Kit (Total Antioxidant Capacity Colorimetric assay kit, produced by Cayman Chemical Co.), and ferritin was assayed by immunoturbidimetry.
Results. Lower levels of TAC were observed in BT patients of both countries when compared with controls (1.83 mmol/L vs 2.7 mmol/L in the Italian study group and controls and 2.42 mmol/L vs 3.2 mmol/L in the Greek study group and controls). There were no significant correlations between plasmatic TAC and ferritin. Furthermore, deferasirox was the only chelation treatment in which TAC showed a correlation in both regions.
Conclusion. Our results potentially suggest that the reduced levels of TAC detectable in BT patients could demonstrate their reduced antioxidant defensive mechanisms.
oxidative stress, β-thalassemia major, total antioxidant capacity, chelation therapies, Mediterranean countries
- Walter PB, Macklin EA, Porter J, et al. Inflammation and oxidant stress in β-thalassemia patients. Haematologica. 2008;93:817–825.
- Zurlo MG, De Stefano P, Borgna-Pignatti C, et al. Survival and causes of death in thalassemia major. Lancet. 1989;2:27–30.
- Vichinsky E, Butensky E, Fung E, et al. Comparison of organ dysfunction in transfused patients. American J Hematology. 2005;80:70–74.
- Pavlova LE, Savov VM, Petkov HG, Charova IP. Oxidative stress in patients with β-thalassemia major. Prilozi. 2007;28:145–154.
- Akça H, Polat A, Koca C. Determination of total oxidative stress and total antioxidant capacity before and after the treatment of iron-deficiency anemia. J Clin Lab Anal. 2013;27:227–230.
- Prus E, Fibach E. Effect of iron chelators on labile iron and oxidative status of thalassemic erythroid cells. Acta Haematologica. 2010;123:14–20.
- Van Zwieten R, Verhoeven AJ, Roos D. Inborn defects in the antioxidant systems of human red blood cells. Free Rad Biol Med. 2014;67:377–386.
- Awadallah S, Arrayed A, Bahareth E, Saeed Z. Total antioxidant capacity and ischemia modified albumin in beta thalassemia. Clin Lab. 2013;59:687–691.
- Bazvand F, Shams S, Esfahani M, et al. Total antioxidant status in patients with major β-thalassemia. Iran J Ped. 2011;21:159–165.
- Livrea MA, Tesoriere L, Pintaudi AM, et al. Oxidative stress and antioxidant status in β-thalassemia major: Iron overload and depletion of lipid-soluble antioxidants. Blood. 1996;88:3608–3614.
- Ghone RA, Kumbar KM, Suryakar AN, Katkam RV, Joshi NG. Oxidative stress and disturbance in antioxidant balance in beta thalassemia major. Ind J Clin Biochem. 2008;23:337–340.
- Fibach E, Rachmilewitz EA. The role of antioxidants and iron chelators in the treatment of oxidative stress in thalassemia. Annals of New York Academy of Sciences. 2010;202:10–16.
- Richards RS, Roberts TK, Dunstan RH, McGregor NR, Butt HL. Erythrocyte antioxidant systems protect cultured endothelial cells against oxidant damage. Biochem Mol Biol Int. 1998;46:857–865.
- Sengsuk C, Tangvarasittichai O, Chantanaskulwong P, et al. Association of iron overload with oxidative stress, hepatic damage and dyslipidemia in transfusion-dependent β-thalassemia/HbE patients. Ind J Clin Biochem. 2014;9:298–305.
- Shazia Q, Mohammad ZH, Rahman T, Shekhar HU. Correlation of oxidative stress with serum trace element levels and antioxidant enzyme status in beta thalassemia major patients. Anemia. 2012;2012:7.
- Kalpravidh RW, Siritanaratkul N, Insain P, et al. Improvement in oxidative stress and antioxidant parameters in β-thalassemia/HbE patients treated with curcuminoids. Clin Biochem. 2010;43:424–429.
- Van Zoeren-Grobben D, Lindeman JH, Houdkamp E, Moison RM, Wijnen JT, Berger HM. Markers of oxidative stress and antioxidant activity in plasma and erythrocytes in neonatal respiratory distress syndrome. Acta Paediatrica. 1997;86:1356–1362.
- Roos D, Eckmann CM, Yazdanbakhsh M, Hamers MN, de Boer M. Excretion of superoxide by phagocytes measured with cytochrome entrapped in released erythrocyte ghosts. J Biol Chem. 1984;10:1770–1775.
- Kampa M, Nistikaki A, Tsaousis V, Maliaraki N, Notas G, Castanas E. A new automated method for the determination of the Total Antioxidant Capacity (TAC) of human plasma, based on the crocin bleaching assay. BMC Clin Pathol. 2002;2:3.
- Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem. 2004;37:277–285.
- Hamed EA, Elmelegy NT. Renal functions in pediatric patients with beta-thalassemia major: Relation to chelation therapy: Original prospective study. Italian J Pediatrics. 2010;25:36–39.
- Veríssimo MP, Loggetto SR, Fabron Junior A, et al. Thalassemia Association protocol for iron chelation therapy in patients under regular transfusion. Revisa Brasileira de Hematologia e Hemoterapia. 2013;35:428–434.
- Hori A, Mizoue T, Kasai H, et al. Body Iron Store as a predictor of oxidative DNA damage in healthy men and women. Cancer Science. 2010;101:517–522.
- Jomova K, Valko M. Importance of iron chelation in free radical-induced oxidative stress and human disease. Current Pharmaceutical Design. 2011;17:3460–3473.
- Yanpanitch OU, Hatairaktham S, Charoensakdi R, et al. Treatment of β-thalassemia/hemoglobin E with antioxidant cocktails results in decreased oxidative stress, increased hemoglobin concentration and improvement of the hypercoagulable state. Oxidative Medicine and Cellular Longevity. 2015;2015:8.
- Rivara MB, Ikizler TA, Ellis CD, Mehrotra R, Himmelfarb J. Association of plasma F2-isoprostanes and isofurans concentrations with erythropoiesis-stimulating agent resistance in maintenance hemodialysis patients. BMC Nephrology. 2015;16:74–79.