Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Effects of α-tocopherol on hemolysis and oxidative stress markers on red blood cells in β-thalassemia major

  • Sovira, Nora (Division of Pediatric Emergency & Intensive Care, Department of Pediatrics, Faculty of Medicine, University of Syiah Kualal/Dr. Zainoel Abidin Hospital) ;
  • Lubis, Munar (Division of Pediatric Emergency & Intensive Care, Department of Pediatrics, Faculty of Medicine, University of Sumatera Utara/University of Sumatera Utara Hospital) ;
  • Wahidiyat, Pustika Amalia (Division of Hematology Oncology, Department of Pediatrics, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital) ;
  • Suyatna, Franciscus D. (Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital) ;
  • Gatot, Djajadiman (Division of Hematology Oncology, Department of Pediatrics, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital) ;
  • Bardosono, Saptawati (Department of Nutrition, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital) ;
  • Sadikin, Mohammad (Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital)
  • Received : 2019.05.20
  • Accepted : 2020.02.18
  • Published : 2020.08.15
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Abstract

Background: The accumulation of unpaired α-globin chains in patients with β-thalassemia major may clinically create ineffective erythropoiesis, hemolysis, and chronic anemia. Multiple blood transfusions and iron overload cause cellular oxidative damage. However, α-tocopherol, an antioxidant, is a potent scavenger of lipid radicals in the membranes of red blood cells (RBCs) of patients with β-thalassemia major. Purpose: To evaluate the effects of α-tocopherol on hemolysis and oxidative stress markers on the RBC membranes of patients with β-thalassemia major. Methods: Forty subjects included in this randomized controlled trial were allocated to the placebo and α-tocopherol groups. Doses of α-tocopherol were based on Institute of Medicine recommendations: 4-8 years old, 200 mg/day; 9-13 years old, 400 mg/day; 14-18 years old, 600 mg/day. Hemolysis, oxidative stress, and antioxidant variables were evaluated before and after 4-week α-tocopherol or placebo treatment, performed before blood transfusions. Results: Significant enhancements in plasma haptoglobin were noted in the α-tocopherol group (3.01 mg/dL; range, 0.60-42.42 mg/dL; P=0.021). However, there was no significant intergroup difference in osmotic fragility test results; hemopexin, malondialdehyde, reduced glutathione (GSH), or oxidized glutathione (GSSG) levels; or GSH/GSSG ratio. Conclusion: Use of α-tocopherol could indirectly improve hemolysis and haptoglobin levels. However, it played no significant role in oxidative stress or as an endogen antioxidant marker in β-thalassemia major.

Keywords

References

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