Ischemia modified albumin in children with transfusion-dependent β-thalassemia: a new marker for an old problem

Mousa, Suzan Omar; Afifi, Mohamed; Saedii, Ahmed; El-Setohy, Alaa A

doi:10.4103/1110-1067.186397

Cited by 7 publications

(14 citation statements)

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“…49 Deferasirox iron-chelation therapy can act as an antioxidant by decreasing intra- and extracellular toxic iron species and reducing oxidative stress in patients with thalassemia. 50 –52 Reactivation or augmentation of hemoglobin F (HbF) using hydroxyurea is also a possible therapeutic approach for patients with β-TI. 53,54 Other actions of hydroxyurea, in particular, its effects on vascular endothelium, adhesion molecule expression, and cytokine production, may also play a role in the final therapeutic outcome.…”

Section: Discussionmentioning

confidence: 99%

Soluble fms-Like Tyrosine Kinase 1 as a Link Between Angiogenesis and Endothelial Dysfunction in Pediatric Patients With β-Thalassemia Intermedia

Tantawy

Adly

Ismail

et al. 2017

Clin Appl Thromb Hemost

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Endothelial damage has been implicated in the pathogenesis of vascular complications in b-thalassemia intermedia (b-TI). Soluble fms-like tyrosine kinase 1 (sFLT-1) is a member of the vascular endothelial growth factor receptor (VEGFR) family. Soluble fmslike tyrosine kinase 1 is an antiangiogenic protein that induces endothelial dysfunction by adhering to and inhibiting VEGF and placenta growth factor. The aim of this study was to assess the level of sFLT-1 in 35 children and adolescents with b-TI, correlating it with markers of hemolysis and iron overload as well as cardiopulmonary complications. Patients were studied focusing on the history of cardiac disease, splenectomy, transfusion, chelation/hydroxyurea therapy, serum ferritin, and sFLT-1 levels. Echocardiography and measurement of carotid intima-media thickness (CIMT) were done for all participants. Soluble fms-like tyrosine kinase 1 was significantly higher in TI patients compared to the control group (median [interquartile range], 110 pg/mL versus 70 [60-90] pg/mL; P < .001). Splenectomized patients and those who had pulmonary hypertension risk or heart disease had higher sFLT-1 levels than those without (P < .001). The sFLT-1 cutoff value that differentiates patients with and without pulmonary hypertension risk or heart disease was determined. Soluble fms-like tyrosine kinase 1 was lower among patients who received chelation therapy and/or hydroxyurea. Significant positive relations were observed between sFLT-1 and lactate dehydrogenase, serum ferritin, liver iron concentration, tricuspid regurgitant jet velocity, and CIMT. We suggest that sFLT-1 represents a link between angiogenesis, endothelial dysfunction, and subclinical atherosclerosis. Measurement of sFLT-1 as a marker of vascular dysfunction in b-TI may provide utility for early identification of patients at increased risk of cardiopulmonary complications.

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Section: Discussionmentioning

confidence: 99%

Soluble fms-Like Tyrosine Kinase 1 as a Link Between Angiogenesis and Endothelial Dysfunction in Pediatric Patients With β-Thalassemia Intermedia

Tantawy

Adly

Ismail

et al. 2017

Clin Appl Thromb Hemost

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“…This in turn leads to increase in redox active fractions such as nontransferrin-bound iron (NTBI) and labile plasma iron (LPI) in the circulation. 4,5 Excessive iron catalyses the production of a variety of reactive oxygen species (ROS), leading to cumulative cell damage. 4,5 Generation of ROS can modify the Nterminal region of albumin and produce an increase in IMA levels.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Excessive iron catalyses the production of a variety of reactive oxygen species (ROS), leading to cumulative cell damage. 4,5 Generation of ROS can modify the Nterminal region of albumin and produce an increase in IMA levels. Albumin in which the N-terminus is either damaged or occupied by copper is termed as IMA.…”

Section: Introductionmentioning

confidence: 99%

“…4 Recently, it was found that IMA is an end product of oxidative stress. 5 Elevated levels of IMA may reflect a generalised rather than organ specific state of oxidative stress. 5 It has also been demonstrated that thalassemia patients experience decreased antioxidant capacity.…”

Section: Introductionmentioning

confidence: 99%

“…5 Elevated levels of IMA may reflect a generalised rather than organ specific state of oxidative stress. 5 It has also been demonstrated that thalassemia patients experience decreased antioxidant capacity. 4 Therefore, effective iron chelators are required to remove the toxic irons to prevent oxidative damage in the vital organs.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Ischaemia Modified Albumin as a Marker of Oxidative Stress in Beta Thalassemia Major Children

Kumar

Bhagiratha

Vishwanath

2021

J. Nepal Paedtr. Soc.

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Introduction: Iron overload in thalassemia catalyses the production of a variety of reactive oxygen species leading to cumulative cell damage. Ischemia modified albumin (IMA) is an end product of oxidative stress. It is imperative to pick up oxidative stress early in order to prevent the organ damage in thalassemia. Therefore this study was undertaken to estimate IMA levels and to see the correlation between ferritin and IMA to establish whether ferritin can be a proxy marker for oxidative stress. Methods: A total of 76 children were included in the study out of which 46 were diagnosed cases of β- Thalassemia major and 30 formed the healthy controls. Pre transfusion haemoglobin, AST, ALT, ferritin and IMA levels were estimated and compared with healthy control children. Correlation was drawn between haemoglobin, AST, ALT, ferritin with IMA. Results: There is significant elevation in the level of IMA and ferritin in children with Thalassemia major as compared to the healthy controls (p = < 0.001). There was a significant positive correlation between ferritin and IMA and a significant negative correlation between haemoglobin % and IMA. Regression relationship between ferritin and IMA established that IMA (ng/ mL) = 246.118 + 0.829 (Ferritin ng/dL). Conclusions: IMA levels were significantly elevated in β- thalassemia major children and correlated positively with ferritin levels. By establishing a regression relationship between ferritin and IMA levels, we can fairly estimate the levels of IMA. Hence, we can utilise ferritin as a proxy marker of oxidative stress instead of IMA.

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Current status of beta‐thalassemia and its treatment strategies

Ali

Shakir

Khan

et al. 2021

Molec Gen & Gen Med

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Ischemia modified albumin in children with transfusion-dependent β-thalassemia: a new marker for an old problem

Cited by 7 publications

References 1 publication

Soluble fms-Like Tyrosine Kinase 1 as a Link Between Angiogenesis and Endothelial Dysfunction in Pediatric Patients With β-Thalassemia Intermedia

Soluble fms-Like Tyrosine Kinase 1 as a Link Between Angiogenesis and Endothelial Dysfunction in Pediatric Patients With β-Thalassemia Intermedia

Evaluation of Ischaemia Modified Albumin as a Marker of Oxidative Stress in Beta Thalassemia Major Children

Current status of beta‐thalassemia and its treatment strategies

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