Clin Exp Pediatr.  2020 Aug;63(8):314-320. 10.3345/cep.2019.00542.

Effects of α-tocopherol on hemolysis and oxidative stress markers on red blood cells in β-thalassemia major

• Sovira N
• Lubis M
• Wahidiyat PA
• Suyatna FD
• Gatot D
• Bardosono S
• Sadikin M

• KMID: 2504934
• DOI: http://doi.org/10.3345/cep.2019.00542

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.

Keyword

α-Tocopherol; Hemolysis; Oxidative stress; β-Thalassemia major