Iron Deficiency Anemia: Recovery from in vitro Oxidative Stress

Abstract

Red blood cells in iron deficiency anemia (IDA) have a decreased activity of essential antioxidant enzymes. The present study examined the effect of in vitro exposure to oxidative agents in IDA cells and their recovery capacity. Red cells of 26 IDA patients and 10 healthy subjects were examined. Cells of IDA patients had higher levels of reduced glutathione (GSH), and normal methemoglobin and malonyldialdehyde (MDA) levels. Exposure to butyl hydro-peroxide revealed a dose-dependent sensitivity in IDA cells, with extensive GSH depletion and increased MDA levels. These changes were partially reversible by incubation with dithiothreitol. Exposure to phenazine methosulfate, to produce intracellular superoxide ions, resulted in moderate GSH depletion and methemoglobin production. IDA cells were more sensitive than control cells to high concentrations of this substance. This effect was further augmented by preincubation with a superoxide dismutase inhibitor. Our data demonstrate that IDA cells are more susceptible to oxidation but have good capacity for recovery.

Oxidative status in iron‐deficiency anemia

“…In the literature (9,14,19), microcytic red blood cells had higher susceptibility to oxidant and high malonyldialdehyde production. Similarly, our results indicated that blood ROS concentrations were higher in patients with IDA than controls.…”

Leukocyte DNA damage in children with iron deficiency anemia: effect of iron supplementation

“…The majority of studies on oxidative stress in IDA are based on lipid peroxidation measurements, and their results are contradictory. It has been determined that red blood cell susceptibility to in vitro oxidation is increased in IDA patients [4,32]; however, some authors have suggested that there is no evidence of increased susceptibility of red blood cells to lipid peroxidation [1,23]. Biomolecular targets of free radicals extend beyond lipids, and DNA oxidation may have more severe consequences.…”

Iron-deficiency anaemia enhances red blood cell oxidative stress

“…Iodoacetamide inhibits GSHPX by reacting with GSH and inhibits perroxiredoxin by reacting with the protein thiol groups [35]. Interestingly, a decrease in GSHPX activity has been reported in iron deficiency anemic patients and experimentally induced iron deficiency anemic rabbits [5,13,16,18]. With a reduction of GSHPX activity, there is an increase in the hydrogen peroxide generated at the surface of the membrane that is not neutralized.…”

“…Increased oxidative stress during anemia is supported by increased lipid peroxidation [5,7,13–17], a decrease in antioxidant defense enzymes including glutathione peroxidase [5,13,16] and a greater susceptibility to the addition of pro-oxidants [18,19]. The presence of oxidative stress in RBCs during anemia has, however, not been consistently observed [20,21].…”