Ischemia modified albumin as a marker of oxidative stress in β-thalassemia Patients: relation to lipid peroxidation, iron overload and vascular dysfunction

Abstract

β-thalassemia major is an inherited disease resulting from reduction or total lack of beta globin chains. Patients with this disease need repeated blood transfusion for survival. This may cause oxidative stress and tissue injury due to iron overload. Ischemia modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress. ROS resulting from conditions such as ischemia, hypoxia, acidosis, free radicals, and free iron can decrease the ability of the N-terminus to bind with transition metals. Under such conditions, the structure of human serum albumin is modified in such a way that permits for excessive production of IMA. The aim of this work was to measure the levels of IMA in β-thalassemia patients as a marker of oxidative stress, and to assess its relation to lipid peroxidation as well as the effect on vascular complications and the efficacy of iron chelation. This study included 45 β-TM patients (25 males and 20 females) recruited from the regular attendants of the Pediatric Hematology Clinic, Pediatric Hospital, Ain Shams University. Patients were compared with 30 age- and sex-matched healthy subjects (18 males and 12 females) enrolled as controls. The mean age of thalassemia patients was 14.3 ± 2.9 years (range: 6-18 years) while that of controls was 13.1 ± 1.9 years (range: 10-17 years). All included patients were subjected to detailed Summary  132 medical history and thorough clinical examination with special emphasis on anthropometric measures, disease duration, evidence of thrombosis, hepatic or cardiac disease, history of splenectomy, transfusion history and chelation therapy. Compliance was assessed by reviewing patient self-report. IMA levels were measured by enzyme linked immunosorbent assay (ELISA) and MDA was assessed by measuring the production of Thiobarbituric Acid Reactive Substances (TBARS). Echocardiography was performed and carotid intima media thickness (CIMT) was measured using Doppler ultrasound.