A New Perspective for Potential Organ Damage Due to Iron-Mediated Oxidation in Thalassemia Major Patients

Abstract

Background: The aim of this study is to develop new perspectives to prevent or reduce potential organ damage due to iron-mediated oxidation in thalassemia major patients. Methods: Seventy patients were included in this study. Blood samples were taken from the patients before and after transfusion. Total thiol, native thiol, disulfide, disulfide/native thiol percentage ratio, ischemia modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS), and ferroxidase levels were determined. Additionally, undepleted thiol level (UTL) was determined as a new parameter associated with organ damage. Results: After transfusion, the levels of native thiol, total thiol, disulfide, TAS, ferroxidase, and TOS were higher, while the IMA levels and disulfide/native thiol percent ratio were lower. Significant correlations were found between antioxidant and oxidant tests before and after transfusion. Additionally, a negative correlation was found between the TOS and UTL levels of the patients measured before the transfusion. Conclusion: In the present study, transfusion therapy increased both oxidation and the antioxidant levels. In addition, the term UTL has been introduced as a parameter that enables the determination of the oxidation level that may cause potential organ damage in transfusion-dependent thalassemia patients.

Oxidative Stress and Antioxidant Status in Adult Patients with Transfusion-Dependent Thalassemia: Correlation with Demographic, Laboratory, and Clinical Biomarkers

“…For it concerns the antioxidant status, available results are quite conflicting, as the estimation of the total antioxidant capacity using different methods (which are not totally equivalent) or single antioxidants may be found increased in TDT, and as such considered as a compensatory response to an increased oxidant status, or effectively reduced and restored (or partially restored) after antioxidant supplementation [41][42][43][44][45][46]. These controversial data may depend by different reasons: the biomarker evaluated, the sample (e.g., erythrocytes, peripheral blood mononuclear cells, plasma or serum), or even proximity to transfusion [47,48]. Moreover, mutual cooperation among the different antioxidants may better face the oxidant attack, and thus the overall antioxidant capacity, reflecting the cumulative effect of all antioxidants present in the blood, may likely give more relevant biological information on the antioxidant barrier action compared to that obtained by the assessment of an individual antioxidant component.…”