Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major.
Clin Exp Pediatr. 2020 Nov 3. Epub 2020 Nov 3. PMID: 33147909
Yasmen A Mohamed
Background: β-Thalassemias are characterized by the presence of mutations in the globin gene that result in the absence or reduced synthesis of β-globin chains of the hemoglobin tetramer. Several studies have reported increased oxidative stress in β-thalassemia major (β-TM) patients. N-acetylcysteine (NAC),a derivative of L-cysteine amino acid, is commonly used as a mucolytic drug. Numerous studies have reported efficient antioxidant activity of NAC.
Purpose: To evaluate the effects of NAC on oxidative stress status and hemoglobin levels in children withβ-TM.
Methods: This study was conducted between June and December 2019. One hundredβ-TM patients were divided into two groups: 50 received NAC 10 mg/kg orally for 3 months (treatment group), while the other 50 received no treatment (non-treatment group). Total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and hemoglobin (Hb) and ferritin levels were measured and compared between groups.
Results: At the end of the study period, Hb and TAC levels were significantly higher in the treatment group than in the non-treatment group (P<.001 and .01, respectively). On the other hand, serum ferritin levels, TOS, and OSI were significantly lower (P = .004, .01, and .001, respectively) in the treatment group.
Conclusion: NAC can effectively reduce the oxidative status and increase the pre-transfusion Hb levels in children withβ-TM. Furthermore, NAC could reduce iron overload in these patients.