The role of antioxidants and iron chelators in the treatment of oxidative stress in thalassemia.
On the basis of all the presented data, one can conclude that oxidative stress plays a major role in the pathophysiology of thalassemia and other congenital and acquired hemolytic anemias. Free extracellular (labile plasma iron, LPI) and intracellular (labile iron pool, LIP) iron species that have been identified in thalassemic blood cells are responsible for generation of oxidative stress by catalyzing formation of oxygen radicals over the antioxidant capacity of the cell. Consequently, there is a rationale for iron chelation to eliminate the free-iron species, which in this respect, act like antioxidants. In addition, antioxidants such as vitamin E and polyphenols are also capable of ameliorating increased oxidative stress parameters and, given together with iron chelators, may provide a substantial improvement in the pathophysiology of hemolytic anemias and particularly in thalassemia.
Fibach
Eitan
E
Department of Hematology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel. Fibach@yahoo.com
Rachmilewitz
Eliezer A
EA
D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D029441:Carica / Q000737:chemistry; D003474:Curcumin / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000737:chemistry / Q000378:metabolism / Q000633:toxicity; D007502:Iron Chelating Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019190:Iron Overload / Q000378:metabolism / Q000503:physiopathology; D010084:Oxidation-Reduction; D018384:Oxidative Stress / Q000187:drug effects*; D028321:Plant Preparations / Q000494:pharmacology / Q000627:therapeutic use; D017382:Reactive Oxygen Species / Q000378:metabolism; D013789:Thalassemia / Q000188:drug therapy* / Q000503:physiopathology
D000975:Antioxidants; D007502:Iron Chelating Agents; D028321:Plant Preparations; D017382:Reactive Oxygen Species; D007501:Iron; D003474:Curcumin