The Effect of Deferasirox on the Oxidative Stress and Inflammation in Iron Overloaded Beta-Thalassemic Patients

Jihad Hemid, Ali; Naji Al-Shimmary, Hussein; A. Latif, Abdul-Razzak

	The Effect of Deferasirox on the Oxidative Stress and Inflammation in Iron Overloaded Beta-Thalassemic Patients
Medical Journal of Babylon
Article 1, Volume 10, Issue 1, 2013, Pages 257-264
Authors
Ali Jihad Hemid; Hussein Naji Al-Shimmary; Abdul-Razzak A. Latif
Abstract
Iron overload represents a serious complication in transfusion dependent β-thalassemic patients. Once the body’s storage capacity is exceeded, free iron catalyzes the formation of highly reactive oxygen species, which leads to membranes, DNA and protein damage. This process leads to cellular death, tissue necrosis and inflammatory reaction in multiple organs particularly liver, heart, and endocrine glands. Indeed organs failure due to chronic iron overload represent the major cause of death in patients with β-thalassemia major who receive blood transfusions regularly. Iron chelation represents life-saving therapy that lead to a significant improvement in the survival of transfusion dependent β-thalassemic patients. Deferasirox is an orally administered once daily iron chelator that mobilize tissue iron by forming soluble stable complexes with iron that are then excreted in feces. This study aimed to evaluate the effect of deferasirox treatment on the oxidative stress and inflammation in iron overloaded β-thalassemic patients. Forty one β-thalassemia major patients were enrolled in this study they were diagnosed by specialist pediatric physicians depending on the clinical features, family history and confirmed by laboratory analysis of blood film, Hb-electrophoresis and serum ferritin. They were free of infections. All patients were on monthly blood transfusion and regular daily oral chelation therapy with deferasirox (30-40mg/kg/day). The patients were monitored monthly for six months by measuring [serum C-reactive protein (CRP), serum malondialdehyde (MDA) and serum glutathione (GSH)]. Base line study for all the above investigations was done. The results showed: There was a significant decrease (P < 0.01) in the means of serum CRP and serum MDA, while there was a significant increase (P < 0.01) in the serum level of GSH after six months of DFX treatment. It was concluded that: Deferasirox can play important role in controlling the oxidative stress and inflammation which are secondary to iron overload. It is noticed from the significant decrease in the oxidative parameter (MDA), the inflammatory parameter (CRP) and from the significant increase in the antioxidant (GSH).

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