title: Oxidant/antioxidant status in children and adolescents with immune thrombocytopenia (ITP) and the role of an adjuvant antioxidant therapy.
abstract: BACKGROUND
  Free oxygen radicals might have an adverse effect on platelets which might be reflected either on its count and/or degree of bleeding severity.
  
  
  OBJECTIVE
  To assess oxidant-antioxidant systems and evaluate effect of antioxidant therapy on platelet count (PC) and bleeding score (BS) in children and adolescents with ITP.
  
  
  METHODS
  Six months prospective randomized single blind study registered as (NCT 01763658) including 39 patients with newly diagnosed (ND) ITP; group 1 (G1) and 39 patients with chronic ITP (G2), each group was randomly allocated (2:1) to one of two subgroups respectively; (G1A and G2A) interventional arm received daily antioxidant therapy, while G1B and G2B; received a placebo. Both groups were compared with healthy controls (n = 39). The primary efficacy endpoints were the difference in the change from baseline to 6 month in ITP specific bleeding assessment tool (ITP-BAT), PC, total antioxidant capacity (TAC), catalase (CAT), reduced glutathione (GSH) and serum malondialdehyde (MDA).
  
  
  RESULTS
  Baseline TAC was significantly lower in patients with (ND) ITP compared to patients with chronic ITP (P < 0.05), both showed significantly lower levels than healthy controls (P < 0.001). At end of study both BS and PC significantly improved in patients receiving antioxidant compared to placebo (P < 0.05). Patients with chronic ITP receiving antioxidant showed better improvement.
  
  
  CONCLUSIONS
  Reduced antioxidant mechanisms were reported in patients with ITP. Antioxidant therapy ameliorated the oxidative stress in both ND and chronic ITP groups which might explain the improvement in both BS and PC.
authors: Mohsen Saleh
authors: MS
authors: Elalfy
authors: Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Mohssen S
authors: MS
authors: Elalfy
authors: Yasmine I
authors: YI
authors: Elhenawy
authors: Shaymaa
authors: S
authors: Deifalla
authors: Marwa
authors: M
authors: Hegazy
authors: Amira
authors: A
authors: Sabra
authors: Yasmine
authors: Y
authors: Abdelaziz
mesh_terms: D000293:Adolescent; D000975:Antioxidants / Q000378:metabolism / Q000627:therapeutic use*; D001792:Blood Platelets; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005978:Glutathione / Q000378:metabolism; D006470:Hemorrhage; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D016877:Oxidants / Q000378:metabolism*; D018384:Oxidative Stress; D011379:Prognosis; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D016037:Single-Blind Method
chemical_list: D000975:Antioxidants; D016877:Oxidants; D005978:Glutathione
keywords: Immune thrombocytopenia; MDA; TAC; antioxidants