Total antioxidant status in sickle cell anemia

Background: The homozygous sickle cell anemia (SCA) has an unstable hemoglobin (HbS). The heme group dissociates easily from globin chain and the iron is released and free within the red cell. In addition, the sickle red cells release cell-free hemoglobin after undergoing intravascular hemolysis. These contribute to increased reactive oxygen species and oxidative stress ensues. Oxidative stress contributes to complications such as acute chest syndrome and pulmonary hypertension both of which are severe manifestations of SCA. Objectives: In this study, we set out to correlate inflammatory markers of disease severity with oxidative stress. Materials and Methods: We compared the total antioxidant status of 61 steady-state SCA patients with 60 HbAA controls. We then investigated associations between the total antioxidant levels and hematological and clinical indices of the patients in order to establish a relationship between markers of oxidative stress and markers of sickle cell severity. Results: We found that that total antioxidants were significantly lower in SCA compared with control levels (50% lower). The total antioxidants levels were inversely proportional to leukocyte and especially neutrophil cell counts which are pro-inflammatory markers. Conclusion: Oxidative stress which leads to secondary complications correlates with pro-inflammatory markers of clinical severity in SCA