Oxidative Stress and Antioxidant Imbalance in Transfusion-Dependent β-Thalassemia Major: A Study from Holy Karbala, Iraq
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β-Thalassemia, oxidative stress, iron overload, antioxidants, Iraq.
Abstract
Background: Iron overload and oxidative stress cause cellular damage and multiorgan failure in β-Thalassemia major, a severe hemoglobinopathy. This research looks on the imbalances of oxidants and antioxidants in Iraqi patients with β-thalassemia who rely on blood transfusions. Methods: Fifty transfusion-dependent β-thalassemia major patients and 50 age- and gender-matched healthy controls from Holy Karbala, Iraq, were enrolled. Serum iron, ferritin, TIBC, MDA, SOD, GPX and vitamins E and C were measured. Statistical analyses included t-tests and Pearson correlation coefficients. Results: Compared to controls, patients exhibited significantly higher serum iron (p < 0.05), ferritin (1840 ± 420 vs. 82 ± 16 ng/ml, p < 0.001), and MDA (6.22 ± 2.31 vs. 2.38 ± 0.53 μmol/l, p < 0.001), indicating iron overload and lipid peroxidation. SOD (40.32 ± 10.22 vs. 15.82 ± 8.15 U/ml, p < 0.01) and GPX (15.22 ± 4.44 vs. 10.22 ± 5.33 U/l, p < 0.05) activities were elevated, reflecting compensatory antioxidant responses. Conversely, vitamins E (0.61 ± 0.22 vs. 1.61 ± 0.10 mg/dl, p < 0.001) and C (4.86 ± 1.22 vs. 17.34 ± 4.78 mg/l, p < 0.001) were significantly reduced, with negative correlations to ferritin (r = -0.68) and MDA (r = -0.55). Conclusion: Iron overload in β-thalassemia major drives oxidative stress, depleting non-enzymatic antioxidants despite enhanced enzymatic defenses. Monitoring MDA and antioxidant levels may optimize chelation therapy and guide antioxidant supplementation to mitigate oxidative damage.
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