Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major

Mohamed, Yasmen A.; Meabed, Mohamed H.; Ashraf, Amany; Morgan, Dalia Saber; Latif, Mostafa G Abdul; Abd-Elkareem, Rehab M.; Ahmed, Heba Mostafa

doi:10.3345/cep.2020.00227

Cited by 2 publications

(6 citation statements)

References 11 publications

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“…Age is an important factor in oxidative stress status and antioxidant capacity and consequently on the response to antioxidant therapy in thalassemia patients. As children affected by thalassemia showed increased TAC compared to healthy individuals 16,17 as well as good clinical response to antioxidant agents in our pooled meta-analysis and in some other studies 2,4 .…”

Section: Discussionsupporting

confidence: 65%

“…By screening the titles and abstracts, 1009 papers were excluded, so 60 full texts were screened. Finally, sixarticles met the inclusion criteria in our analysis 1,2,4,5,9,10 (Figure 1, PRISMA). The general characteristics of the included studies were summarized in Tables 1and2.…”

Section: Resultsmentioning

confidence: 99%

“…Transfusion-dependent thalassemia(TDT)is one of the most common inherited disorders caused by a genetic mutation leading to hemolysis and impaired erythropoiesis [1][2][3] . Regular blood transfusion is an essential therapeutic option that has lowered the complications of severe anemia and increased patients' survival.…”

Section: Introductionmentioning

confidence: 99%

“…N-acetyl cysteine (NAC)a mucolytic agent and paracetamol antidote has been determined as an antioxidant supplement in recent years 8 . The effects of NAC and Vitamin E as the two major groups of antioxidants have been investigated on hemolytic parameters and oxidative status of patients with TDT with controversial results 1,2,4 .…”

Section: Introductionmentioning

confidence: 99%

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The Effect of N-Acetyl Cysteine and Vitamin E on Oxidative Status and Hemoglobin Level in Transfusion-Dependent Thalassemia Patients: A Systematic Review and Meta-Analysis

Haghpanah¹,

Hosseini-Bensenjan²,

Zekavat³

et al. 2021

Preprint

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This meta-analysis was conducted to summarize the comparative effect of NAC and Vitamin E on oxidative status, including total antioxidant capacity (TAC), total oxidative stress (TOS), oxidative stress index (OSI), and hemoglobin (Hb) in patients with TDT.All methods were performed in accordance with the PRISMA checklist. We searched databases including Web of Science (ISI), Scopus, PubMed, and Embase. Meta-analysis was done using Stata statistical software version 16.0.Finally,four randomized-controlled trials (RCT)for NAC and four RCTs for Vitamin E were included.Our meta-analyses showed a significant increase in the weighted mean differences (WMD) of Hband a significant decrease in the WMD of OSI in the NAC group.In subgroup analysis based on age: in the NAC group, a significant increase in the WMD of TAC andHband a significant decrease in the WMD of TOS were detectedonly in children. In theVitamin E group, a significant increase in Hb and a significantdecrease in TOS and OSI were determined in the children subgroup as well.NAC can be used as an effective antioxidant supplementparticularlyin children with TDT. Also, Vitamin Eshowed a beneficial antioxidant effect in TDT children. So, more well-designed randomized, controlled trials for the effect of NAC in adult TDT andthe effect of vitamin E both in adults and children are recommended with more focus on theessential influencing factors on the oxidative status in TDT patients.

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Section: Discussionsupporting

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of N-Acetyl Cysteine and Vitamin E on Oxidative Status and Hemoglobin Level in Transfusion-Dependent Thalassemia Patients: A Systematic Review and Meta-Analysis

Haghpanah¹,

Hosseini-Bensenjan²,

Zekavat³

et al. 2021

Preprint

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“…It exerts its effects either directly by quenching some oxidants or indirectly by acting as a precursor of cysteine, which is the rate-limiting step in glutathione production. 23 NAC attenuates iron overload-induced brain dysfunction and apoptosis by decreasing iron levels in both the blood and the brain, with its ability to cross the BBB. 24 Recently, formulating new drugs and functional foods from whey proteins has attracted great interest for their antioxidant properties.…”

mentioning

confidence: 99%

Acetylated oligopeptide and N‐acetylcysteine protect against iron overload‐induced dentate gyrus hippocampal degeneration through upregulation of Nestin and Nrf2/HO‐1 and downregulation of MMP‐9/TIMP‐1 and GFAP

Kamel,

Nassar,

Meligy

et al. 2024

Cell Biochemistry & Function

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Iron accumulation in the brain causes oxidative stress, blood–brain barrier (BBB) breakdown, and neurodegeneration. We examined the preventive effects of acetylated oligopeptides (AOP) from whey protein on iron‐induced hippocampal damage compared to N‐acetyl cysteine (NAC). This 5‐week study used 40 male albino rats. At the start, all rats received 150 mg/kg/day of oral NAC for a week. The 40 animals were then randomly divided into four groups: Group I (control) received a normal diet; Group II (iron overload) received 60 mg/kg/day intraperitoneal iron dextran 5 days a week for 4 weeks; Group III (NAC group) received 150 mg/kg/day NAC and iron dextran; and Group IV (AOP group) received 150 mg/kg/day AOP and iron dextran. Enzyme‐linked immunosorbent assay, spectrophotometry, and qRT‐PCR were used to measure MMP‐9, tissue inhibitor metalloproteinase‐1 (TIMP‐1), MDA, reduced glutathione (GSH) levels, and nuclear factor erythroid 2‐related factor 2 (Nrf2) and heme oxygenase‐1 (HO‐1) gene expression. Histopathological and immunohistochemical detection of nestin, claudin, caspase, and GFAP was also done. MMP‐9, TIMP‐1, MDA, caspase, and GFAP rose in the iron overload group, while GSH, Nrf2, HO‐1, nestin, and claudin decreased. The NAC and AOP administrations improved iron overload‐induced biochemical and histological alterations. We found that AOP and NAC can protect the brain hippocampus from iron overload, improve BBB disruption, and provide neuroprotection with mostly no significant difference from healthy controls.

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Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major

Abstract: Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major

Cited by 2 publications

References 11 publications

The Effect of N-Acetyl Cysteine and Vitamin E on Oxidative Status and Hemoglobin Level in Transfusion-Dependent Thalassemia Patients: A Systematic Review and Meta-Analysis

The Effect of N-Acetyl Cysteine and Vitamin E on Oxidative Status and Hemoglobin Level in Transfusion-Dependent Thalassemia Patients: A Systematic Review and Meta-Analysis

Acetylated oligopeptide and N‐acetylcysteine protect against iron overload‐induced dentate gyrus hippocampal degeneration through upregulation of Nestin and Nrf2/HO‐1 and downregulation of MMP‐9/TIMP‐1 and GFAP

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