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Antioxidant vitamins C and E supplementation increases markers of haemolysis in sickle cell anaemia patients: a randomized, double-blind, placebo-controlled trial.
Br J Haematol. 2013 Mar; 160(5):688-700.BJ

Abstract

Erythrocytes from sickle cell anaemia (SCA) patients continuously produce larger amounts of pro-oxidants than normal cells. Oxidative stress seems to primarily affect the membrane and results in haemolysis. The use of antioxidants in vitro reduces the generation of pro-oxidants. To evaluate the impact of vitamins C (VitC) and E (VitE) supplementation in SCA patients, patients over 18 years were randomly assigned to receive VitC 1400 mg + VitE 800 mg per day or placebo orally for 180 d. Eighty-three patients were enrolled (44 vitamins, 39 placebo), median age 27 (18-68) years, 64% female. There were no significant differences between the two groups regarding clinical complications or baseline laboratorial tests. Sixty percent of the patients were VitC deficient, 70% were VitE deficient. Supplementation significantly increased serum VitC and E. However, no significant changes in haemoglobin levels were observed, and, unexpectedly, there was a significant increase in haemolytic markers with vitamin supplementation. In conclusion, VitC + VitE supplementation did not improve anaemia and, surprisingly, increased markers of haemolysis in patients with SCA and S-β(0) -thalassaemia. The exact mechanisms to explain this findings and their clinical significance remain to be determined.

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Authors+Show Affiliations

Arruda MM
Hematology and Blood Transfusion Department, Federal University of São Paulo, UNIFESP, São Paulo, Brazil.
Mecabo G
No affiliation info available
Rodrigues CA
No affiliation info available
Matsuda SS
No affiliation info available
Rabelo IB
No affiliation info available
Figueiredo MS
No affiliation info available

MeSH

AdolescentAdultAgedAnemia, Sickle CellAntioxidantsAscorbic AcidBiomarkersDietary SupplementsDouble-Blind MethodDrug UtilizationFemaleHemolysisHospitalizationHumansInflammationMaleMiddle AgedOxidative StressQuality of LifeReactive Oxygen SpeciesSickle Cell TraitThalassemiaVitamin EYoung Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23278176

Citation

Arruda, Martha M., et al. "Antioxidant Vitamins C and E Supplementation Increases Markers of Haemolysis in Sickle Cell Anaemia Patients: a Randomized, Double-blind, Placebo-controlled Trial." British Journal of Haematology, vol. 160, no. 5, 2013, pp. 688-700.
Arruda MM, Mecabo G, Rodrigues CA, et al. Antioxidant vitamins C and E supplementation increases markers of haemolysis in sickle cell anaemia patients: a randomized, double-blind, placebo-controlled trial. Br J Haematol. 2013;160(5):688-700.
Arruda, M. M., Mecabo, G., Rodrigues, C. A., Matsuda, S. S., Rabelo, I. B., & Figueiredo, M. S. (2013). Antioxidant vitamins C and E supplementation increases markers of haemolysis in sickle cell anaemia patients: a randomized, double-blind, placebo-controlled trial. British Journal of Haematology, 160(5), 688-700. https://doi.org/10.1111/bjh.12185
Arruda MM, et al. Antioxidant Vitamins C and E Supplementation Increases Markers of Haemolysis in Sickle Cell Anaemia Patients: a Randomized, Double-blind, Placebo-controlled Trial. Br J Haematol. 2013;160(5):688-700. PubMed PMID: 23278176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antioxidant vitamins C and E supplementation increases markers of haemolysis in sickle cell anaemia patients: a randomized, double-blind, placebo-controlled trial. AU - Arruda,Martha M, AU - Mecabo,Grazielle, AU - Rodrigues,Celso A, AU - Matsuda,Sandra S, AU - Rabelo,Iara B, AU - Figueiredo,Maria S, Y1 - 2012/12/29/ PY - 2012/08/08/received PY - 2012/11/09/accepted PY - 2013/1/3/entrez PY - 2013/1/3/pubmed PY - 2013/4/13/medline SP - 688 EP - 700 JF - British journal of haematology JO - Br J Haematol VL - 160 IS - 5 N2 - Erythrocytes from sickle cell anaemia (SCA) patients continuously produce larger amounts of pro-oxidants than normal cells. Oxidative stress seems to primarily affect the membrane and results in haemolysis. The use of antioxidants in vitro reduces the generation of pro-oxidants. To evaluate the impact of vitamins C (VitC) and E (VitE) supplementation in SCA patients, patients over 18 years were randomly assigned to receive VitC 1400 mg + VitE 800 mg per day or placebo orally for 180 d. Eighty-three patients were enrolled (44 vitamins, 39 placebo), median age 27 (18-68) years, 64% female. There were no significant differences between the two groups regarding clinical complications or baseline laboratorial tests. Sixty percent of the patients were VitC deficient, 70% were VitE deficient. Supplementation significantly increased serum VitC and E. However, no significant changes in haemoglobin levels were observed, and, unexpectedly, there was a significant increase in haemolytic markers with vitamin supplementation. In conclusion, VitC + VitE supplementation did not improve anaemia and, surprisingly, increased markers of haemolysis in patients with SCA and S-β(0) -thalassaemia. The exact mechanisms to explain this findings and their clinical significance remain to be determined. SN - 1365-2141 UR - https://www.unboundmedicine.com/medline/citation/23278176/Antioxidant_vitamins_C_and_E_supplementation_increases_markers_of_haemolysis_in_sickle_cell_anaemia_patients:_a_randomized_double_blind_placebo_controlled_trial_ L2 - https://doi.org/10.1111/bjh.12185 DB - PRIME DP - Unbound Medicine ER -
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