Role of Iron Chelators, Hydroxyurea, and Splenectomy on Serum Total Antioxidant Capacity in β-Thalassemia

Abstract

BACKGROUND: Iron overload is the main cause of oxidative stress in beta-thalassemia (βT) by the increased production of free radicals and reactive oxygen species. Antioxidants counteract the toxic effects of oxidative stress.
 AIM: This study aims to evaluate the total antioxidant capacity (TAC) and the possible impact of splenectomy, iron chelators, and hydroxyurea (hydra) on serum level of TAC.
 MATERIALS AND METHODS: Fifty children and adolescents with βT were studied in comparison to 25 healthy age- and sex-matched subjects. Complete medical history, clinical examination, and laboratory assessment of serum TAC, ferritin, hepcidin, and hemoglobin (Hb) were carried out.
 RESULTS: There was no statistically significant difference between the three groups; thalassemia major (TM), thalassemia intermedia (TI), and controls as regard age and sex. β-TM patients had significantly higher serum ferritin, serum hepcidin, and serum TAC (p < 0.000, 0.002, and 0.000, respectively) than controls. β-TI patients had significantly higher serum ferritin and serum TAC (p < 0.000) than controls. Serum TAC was lower in children with splenectomy, but this difference was not statistically significant. In addition, we observed no statistically significant difference in serum TAC of patients under different (deferasirox or deferiprone) medication. Serum TAC concentration was significantly higher in patients taking hydroxyurea (hydra) (p < 0.010).
 CONCLUSIONS: The study showed an increased level of serum TAC in patients with β-T in comparison with controls. Serum TAC was also increased in those taking hydroxyurea, however, it was low in βT patients under regular chelation therapy, while splenectomy had no significant effect on serum TAC.