Antioxidant therapies for thalassemia

Abstract

© 2014 Nova Science Publishers, Inc. The cellular redox status in physiological condition is normally well-balanced between oxidant and antioxidant levels. Oxidative stress is defined as the disturbance state that the production of the oxidants is greater than the efficiency of the antioxidant system. In the pathogenesis of thalassemia, redox-active iron released from excess unpaired globin chains causes oxidative damage to the membrane of mature or immature red blood cells. This leads to increased premature removal of the affected red cells, ineffective erythropoiesis, chronic anemia, and finally, iron overload. Thus, patients with thalassemia have inevitably profound oxidative stress that triggers oxidation of intracellular biomolecules; causing tissue damage and then organ failure. Therefore, the antioxidant supplementation may be beneficial for the patients with thalassemia. This article briefly summarizes how oxidative stress raises and discusses several therapeutic strategies using antioxidant(s) to neutralize the oxidative burden in thalassemia; including direct scavenging of free radicals, detoxifying or removing oxidants, or boosting endogenous antioxidants. Several studies and clinical trials on the use of potential antioxidant agents such as pharmaceuticals, dietary compounds, and endogenous biomolecules in thalassemia have been reported. Some recent studies showed that various antioxidants when used in combination enhanced antioxidant capacity and decreased toxicity/side effects. Future research should address the optimization of combination strategies with the final goal to prevent hazardous complications and increase life expectancy of thalassemic patients. Moreover, it should focus on the investigation of the potential antioxidants for thalassemia which could be orally administered and readily absorbed, and highly bioavailable. Moreover, they should possess high antioxidative activities, have long half-life, do not interfere with other drugs, and are not toxic even at high concentrations.