Effects Of Deferasirox Therapy On High Sensitivity C-Reactive Protein and Oxidative Stress Markers In Iron Overloaded, Beta-Thalassemic Patients

Abstract

Wasn H. Al-Talib, Zeina A. Althanoon

Objective: The study aimed to investigate the effects of iron chelator deferasirox on markers of oxidative-stress and inflammation in Iron Overloaded blood transfused Beta-Thalassemic Patients by measuring malondialdehyde (MDA), total antioxidant capacity (TAC), antioxidant marker glutathione(GSH) and highly-sensitivity C-reactive protein (hs-CRP) in these patients in comparison with control subjects.
Methods: A total of 105 patients with transfusion dependent β-thalassemia major were participated in this study. They were diagnosed by specialized pediatric physicians at Thalassemic Center in Ibn Al-Atheer Teaching Hospital in Mosul city, Iraq, during the period between October 2019 and March 2020. They were divided into two treatment groups. The first group was β- thalassemic patients treated with monthly regular blood transfusion alone and the second group was β- thalassemic patients treated with daily iron chelation therapy with oral deferasirox (DFX) (30-40mg/kg/day) in addition to regular blood transfusion. Sixty-five healthy, not thalassemic subjects, were also participated in this study as a control group. High sensitive C-reactive protein (hs-CRP), marker of inflammation, serum malondialdehyde (MDA) , marker of oxidative stress , serum glutathione (GSH)and total antioxidant capacity (TAC) , markers of antioxidant capacity were measured for both patients and controls.
Results: It has been found that β- thalassemic patients on DFX therapy had a significant decrease (P < 0.01) in means hs-CRP and MDA levels, and a significant increase (P < 0.01) in TAC and GSH levels as compared with β- thalassemic patients on regular blood transfusion alone and without DFX therapy . In addition , there is highly significant positive correlation between S.ferritin and hs-CRP (r=0.723, P < 0.01), and between S.ferritin and MDA (r= 0.675, P < 0.01), while there is a highly significant negative correlation between ferritin and TAC (r=-0.422, P < 0.01), and between ferritin and GSH (r=- -0.354, P < 0.01).
Conclusion: Iron chelation therapy with DFX was effective in decreasing MDA and hs-CRP and increasing the antioxidant markers (GSH) and TAC in iron overloaded blood transfused beta thalassemic patients. Thus, DFX therapy can play important role in controlling oxidative stress and inflammation in these patients.