The Effects of Chelating Therapy on the Levels of Serum Ferritin, Zinc, Copper & its relation with Malondialdehyde in Patients with B-Thalassemia Major

A Abdulkhader, Abdulkhader

	The Effects of Chelating Therapy on the Levels of Serum Ferritin, Zinc, Copper & its relation with Malondialdehyde in Patients with B-Thalassemia Major
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 23, Issue 3, 2010, Pages 147-152
Author
Abdulkhader A Abdulkhader
Abstract
Background: ß-Thalassemia is a hereditary hemolytic anemia, which needs to be treated by repeated and regular blood transfusions. Multiple transfusions could result in iron overload which is treated by chelating agents. This chelating agent chelates iron and may also chelates zinc and copper which are important components of antioxidant enzymes system. Objectives: Evaluating the effects of chelating therapy on the serum levels of ferritin, Zinc and Cu in B-thalassemia patients and correlate such effects on the antioxidant activity by determining the levels of malondialdehyde (MDA). Patients & Methods: This study was performed during the period from 1st of June to 31st of August 2008. A total of 50 B-thalassemia patients were enrolled in the current study. Patients were from the thalassemia center in Sulaimani city & 50 healthy children consulting Shaheed Hersh Health Center for different reasons were taken as a control group. The blood samples were collected from 50 patients, 25 males and 25 females with different ages, ranging from (2 - 15) years, 37 (74%) of them were taking regular blood transfusions and chelating agent therapies, and 13 (26%) were not taking chelating agent therapies (poor compliance). The determination of the serum levels of copper, zinc, MDA was determined by spectrophotometer method &the level of serum ferritin levels was determined by enzyme immunoassay. Results: Analysis of the data obtained from the 50 ß-thalassemia patients showed that the mean concentration of serum ferritin and MDA was significantly higher, and the mean concentration of serum zinc and copper was significantly lower with respect to the data obtained from the 50 control children. Further analysis of the data were obtained to study the effects of chelating therapy, age, sex and history of splenectomy on the serum levels of ferritin, zinc, copper and MDA among the ß-thalassemic patients which demonstrated that there were no significant differences in the levels of the parameters investigated between those receiving chelating therapy and those not receiving chelating therapy, between different age groups, between males and females and between those with positive history of splenectomy and those without splenectomy, except in the level of MDA in relation to the sex of patients, which was significantly higher in male compared to female ß-thalassemic patients. Conclusion: Significantly low levels of serum zinc and copper were demonstrated among B-thalassemia patients as compared to their levels in normal children. In contrast the serum levels of ferritin and MDA in ß-thalassemia patients were significantly higher with respect to their levels in controls. And this further confirms that oxidative stress may be an important feature of ß-thalassemia patients. Key Words: Thalassemia, Chelating agents, Serum zinc, Copper, Malondialdehyde.
Keywords
Thalassemia; Chelating agents; serum zinc; copper; Malondialdehyde

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