The effect of an intrinsic defect in the red cell and pronounced hypochromia on oxidative damage to RBC membrane lipids was compared in bata-thalassemia and iron deficiency anemia (IDA), which have a vaded etiology but equivalent low hemoglobin content. The study was planned to correlate the etiology of the disorders to the severity of lipid imbalance and RBC hemolysis in membranes of both the conditions. Results Indicated a fall of lysophosphatidylcholine~LPC), phosphatidylethanolemine(PE) and the unsaturated to saturated fatty acid ratlo in both conditions, while phosphat~ylcholine(PC) Increased only in thalassemia. However, irrespective of the disease, sphingomyelin(SM), total cholesterol and phospholipid levels elevated and the hydrogen peroxide stress test Indicated Increased susceptibility of both pathologic RBCs to peroxidation. Present findings Indicate that IDA and thalassemla allow for considerable amounts of oxidative damage to membrane Iipicls, irrespective of their etiologias, and thus point hypochromia as an Important contributor for Inducing lipid Imbalance and RBC hemolysis.
KEYWORDS:Hypochromia, intnnsic defect, oxidation, RBC membrane, lipid imbalance.
UClrRODUCTIONAn i,~,b--=cellular defect in the red blood cell (RBC) can accentuate oxygen radical formation and risk damage to cellular components (1,2). On the other hand, there is some evidence that hypochromia may fadlitate oxidation of the membrane by reducing the buffering protection of hemoglobin (3,4). The med'~misms facilitating oxidative damage to red cells in thalassemia are multifactodal and result from the presence of excess unpaired globin chains and high i,~;~-~ellular content of nonhemogtobin iron, in addition to hypochromia (2,3,5). However, in iron deficiency anemia (IDA), hypochromia is the lone factor that may enhance oxidant-induced threat to the RBC membrane (6). The accumulat|on of activated oxygen can paternally cause hemolysis (3,5,7). Neverlh~ess it is not clear whether the presence of an =intrinsic" defect in the RBC or "hypochromia" is the more Author for correspondence: Dr. V.A.Haldankar, Professor and Head, Department of Biochemistry, at the above address. important factor as far as lipid damage and hemolysis is concerned.In order to correlate the etiology of the disorders to the severity of lipoperoxidation, lipid imbalance and RBC hemolysis, we conducted a comparative inves~gation between beta thalassemia hornozygous and IDA membrane-lipid profiles.
MATERIAL8 AND METHODSIn the present study, 25-transfusion dependent, non-spienectomized (non-spx) beta thalassemia homozygous children (5-12 years) and 35 patients afflicted with IDA ( 22-40 years) attending the hematology out patient department of B.Y.L.Nair Charitable hospital were included with their consent. Age and se~ matched 20 normal children and 30 adult volunteers formed the control groups for thalassemia and IDA respectively. In thalassemia patients, blood v~s collected prior to blood tra~fusion, in an effort to minimize the influence of donor blood ce...