Analysis of oxidative status and biochemical parameters in adult patients with sickle cell anemia treated with hydroxyurea, Ceará, Brazil

Abstract

BackgroundSickle cell anemia is a hemoglobinopathy caused by a mutation that results in the production of an abnormal hemoglobin molecule, hemoglobin S (Hb S). This is responsible for profound physiological changes, such as the sickling of red blood cells. Several studies have shown that hydroxyurea protects against vaso-occlusive crises.ObjectiveThe aim of this study was to evaluate the oxidative stress associated with biochemical parameters in patients with sickle cell anemia treated with hydroxyurea.MethodsThe study was conducted with 20 male and 25 female patients at the Hospital Universitário Walter Cantídio. The patients were divided into two groups: a study group (n = 12), patients with sickle cell anemia who were receiving hydroxyurea and a control group (n = 33) of sickle cell anemia patients not submitted to hydroxyurea treatment. The biochemical parameters analyzed were ferritin, transferrin, and serum iron. Glutathione was measured in its reduced form to analyze the oxidative state.ResultsThe results showed insignificant increases in the levels of serum iron, transferrin and ferritin in patients treated with hydroxyurea when compared with those who did not take the medication. However, the glutathione levels were significantly higher in patients taking hydroxyurea than in controls.ConclusionsThese results indicate that hydroxyurea possibly acts as an antioxidant by increasing glutathione levels.

Serum Paraoxonase Activity and Malondialdehyde Serum Concentrations Remain Unaffected in Response to Hydroxyurea Therapy inβ-Thalassemia Patients

“…10 HU is suggested to produce direct oxidant and indirect antioxidant effects 30 ; however, there have been contradictory reports regarding the protective role of HU therapy in SCD patients. [23][24][25][26] To examine the possible proactive role of HU treatment on oxidative imbalance in β-thalassemia, we studied oxidative stress biomarkers.…”

“…Although the underlying mechanisms for the development of oxidative stress in SCD and β-thalassemia are different, 31 the oxidant/antioxidant ratio seems to be more affected in the latter. 14 On the basis of thiobarbituric acid reactive substances (TBARS) and GSH analysis, a few studies reported an antioxidant role of HU in SCD subjects; 23,24 however, investigations on MDA, 25,26 PON1, 26 and vitamin E 26 have suggested that oxidative damage among SCD patients was independent of HU therapy. It was also argued that the observed discrepancy regarding antioxidant effects of HU therapy might be due to the short treatment period.…”

“…HU is an FDA‐approved drug for the treatment of SCD through reduction in HbS polymerization and vaso‐occlusive crises by fetal hemoglobin augmentation . HU is suggested to produce direct oxidant and indirect antioxidant effects; however, there have been contradictory reports regarding the protective role of HU therapy in SCD patients . To examine the possible proactive role of HU treatment on oxidative imbalance in β‐thalassemia, we studied oxidative stress biomarkers.…”

“…22 HU therapy has been shown to induce GSH concentrations and to reduce lipid peroxidation in SCD patients, thus acting as a protective agent against oxidative stress. 23,24 However, there have been contradicting reports regarding the protective role of HU therapy on oxidative imbalance among SCD patients. 25,26 This potential effect of HU on oxidative stress in β-thalassemia subjects has not been investigated to date.…”

Association of Inflammatory Biomarker C-Reactive Protein, Lipid Peroxidation and Antioxidant Capacity Marker with HbF Level in Sickle Cell Disease Patients from Chattisgarh

“…The antioxidant (FARP) and total thiol levels were significantly positively (p B 0.0001) associated with HbF level in SCD patients. Recent studies have revealed that the use of HU promotes higher levels of HbF in SCA patients and is useful in protecting against the sickling of red blood cells, vaso-occlusion and oxidative stress [34,35]. High HbF expression has ameliorating effects on SCD severity therefore HU treatment may be correlated to lower oxidative status.…”