title: Effect of antioxidant therapy on hepatic fibrosis and liver iron concentrations in β-thalassemia major patients.
abstract: To assess the effects of combined vitamin therapy on oxidant-antioxidant hepatic status and hemoglobin (Hb) derivatives on β-thalassemia major (β-TM), a prospective study of 60 β-TM patients aged 4 to 17 years, was conducted. Thirty-nine patients with initial low serum vitamins E, C and A, were treated with oral combined vitamins for 1 year compared to 21 patients with normal vitamin levels. Serum transaminases, serum ferritin, hepatic fibroscan elastography (TE) and magnetic resonance imaging R2* (MRI R2*) for liver iron concentration (LIC), were assessed before and after 6 and 12 months of therapy. Antioxidant capacity was assessed by levels of reduced glutathione (GSH), malondialdehyde (MDA), catalase, superoxide dismutase and GSH enzymes. The studied vitamins, reduced GSH and Hb levels were significantly elevated and paralleled by progressive decline in MDA and ferritin during therapy (p <0.001). Serum transaminase and superoxide dismutase were significantly decreased, while GSH reductase was significantly elevated during therapy (p <0.001). Improvement of hepatic fibrosis as 23.0% had TE (>12 kPa) at baseline compared to 20.5% after therapy (p >0.05), although LIC values were significantly decreased (p <0.001). Combined vitamin therapy improves the antioxidant/oxidant balance, LIC and hepatic fibrosis in young β-TM patients.
authors.affiliation: Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mohsen S
authors.initials: MS
authors.lastname: Elalfy
authors.forename: Amira A M
authors.initials: AA
authors.lastname: Adly
authors.forename: Atef A M
authors.initials: AA
authors.lastname: Attia
authors.forename: Fatma A
authors.initials: FA
authors.lastname: Ibrahim
authors.forename: Amer S
authors.initials: AS
authors.lastname: Mohammed
authors.forename: Abdelbasset M
authors.initials: AM
authors.lastname: Sayed
mesh_terms: D000293:Adolescent; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000097:blood / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood; D005978:Glutathione / Q000097:blood; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000378:metabolism; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D011446:Prospective Studies; D013482:Superoxide Dismutase / Q000097:blood; D000637:Transaminases / Q000097:blood; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use*; D014810:Vitamin E / Q000097:blood / Q000627:therapeutic use*; D017086:beta-Thalassemia / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D000975:Antioxidants; D014801:Vitamin A; D014810:Vitamin E; D008315:Malondialdehyde; D005293:Ferritins; D013482:Superoxide Dismutase; D000637:Transaminases; D005978:Glutathione; D001205:Ascorbic Acid