Vitamin E effect on osmotic fragility in β thalassemia major

Main Article Content

Agus Fitrianto
Moedrik Tamam
Nyoman Suci Widyastiti

Abstract

Background Blood transfusion remains the main therapy for anemia in β thalassemia major patients. However, frequent transfusions can cause oxidative stress in response to iron overload. Vitamin E is considered to be the best lipid-soluble exogenous antioxidant in humans. It can protect phospholipid membrane from peroxidarion. Erythrocyte osmotic fragility is a useful test to assess for the improvement of red blood cells in thalassemia patients after vitamin E supplementation.

Objective To investigate the effect of vitamin E for improving erythrocyte osmotic fragility in β thalassemia major and for decreasing the need for frequent transfusions.

Methods T his was a double blind placebo controlled randomized clinical trial on children aged 2-14 years with thalassemia major who received frequent blood transfusions. Fifty subjects were divided into 2 groups: group I with vitamin E supplementation and group II with placebo, as a control group, for a period of 1 month. Pre- and post-treatment data on erythrocyte osmotic fragility and hemoglobin level were analyzed with non-paired T-test.

Results Improved erythrocyte osmotic fragility was found: in group I, pre-treatment 31.59 (SD 6.342)% to post-treatment 38.08 (SD 7.165)%, compared to the control group pre-treatment 34.40 (SD 6.985)% to post-treatment 29.26 (SD 9.011)% (P=0.0001). Comparison of the mean delta Hb level in group  I was 0.94 (SD 0.605) gr% and that of group II was - 0.23 (SD 1.199) gr% (P=0.0001).

Conclusion Vitamin E supplementation improves erythrocyte fragility and Hb level in β thalassemia major pediatric patients.

Article Details

How to Cite
1.
Fitrianto A, Tamam M, Widyastiti N. Vitamin E effect on osmotic fragility in β thalassemia major. PI [Internet]. 30Oct.2014 [cited 21Sep.2019];54(5):280-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1008
Section
Articles
Received 2016-11-09
Accepted 2016-11-09
Published 2014-10-30

References

1. Vichinsky EP. Changing patterns of thalassemia worldwide. Ann NY Acad Sci. 2005;1054:18-24.
2. Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med. 2005;353:1135-46.
3. Wahidiyat I. T halassemia dan permasalahannya di Indonesia. In: Finnansyah A, Sastroasmoro S, Trihono PD, Pujiadi A, Tridjaja B, Mulya GD, editors. Naskah Lengkap KONIKA. XI. Jakarta, IDAI; 1999. p. 293-6.
4. Gutteridge JMC, Halliwell B. Antioxidants in nutritions, health, and disease. Oxford: Oxford Oxford Univ Press; 1994. p.120-143.
5. Das N, Das Chowdhury T, Chattopadhyay A, Datta AG. Attenuation of oxidative stress-induced changes in thalassemic erythrocytes by vitamin E. Pol J Pharmacol. 2004;56:85-96.
6. Palasuwan A, Soogarun S, Wiwanitkit V, Luechapudipom R, Pradniwat P, Lertlum T. Preliminary study of the effect of vitamin E supplementation on the antioxidant status of hemoglobinE carriers. Bangkok: Chulalongkom University; 2006. p. 184-9.
7. Singh Sp, Gupta SC. Effectiveness of red cell osmotic fragility test with varying degrees of saline concentration in detecting beta-thalassaemia trait. Singapore Med J. 2008;49:823-6.
8. Attia MMA, Sayed AM, Ibrahim FA, Mohammed AS, El- Alfi MS. Effects of antioxidant vitamins on some hemoglobin properties and erythrocytes in homozygous beta-thalassemia. Rom J Biophys. 2011;21:1-16.
9. Simsek F, Ozturk G, Kemahli S, Erbas D, Hasanoglu A. Oxidant and antioxidant status in beta-thalassemia major patients. J Ankara University Fac Med. 2005;58:34-8.
10. Mahjoub S, Tamaddoni A, Zanjanchi M, Moghadarrmia AA. The effects of beta-carotene and vitamin E on erythrocytes lipid peroxidation in beta-thalassemia patients. J Res Med Sci. 2007;12:301-7.