ROLE OF VITAMIN E, L-CARNITINE AND MELATONIN IN MANAGEMENT OF Β-THALASSEMIA MAJOR

Background:β-thalassemia major is an inherited disease resulting from decrease or total lack of β globin chains. Patients with this disease need repeated blood transfusion for survival. This may cause oxidative stress and tissue injury due to iron overload and depletion of antioxidant enzymes.
Objective:Evaluation the role of vitamin E, L- carnitine and melatonin supplementation in management of β-thalassemia major patients.
Methods: Forty five patients with β-thalassemia major were allocated to three groups A, B and C treated with vitamin E, L-carnitine and melatonin respectively. Serum malondialdehyde, serum reduced glutathione, serum ferritin, Hb, PCV, MCV, MCH, and MCHC levels and RBCs count were measured before and after treatment.
Results:A significant decrease was observed in serum malondialdehyde and ferritin level after therapy in all treated groups; whereas, no significant (P > 0.05) changes in glutathione level after treatment in all groups. Hb level and RBC count increased significantly in group A (vitamin E), whereas, PCV, MCV, MCH and MCHC levels did not change significantly in all treated groups.
Conclusion:Vitamin E, L- carnitine and melatonin have beneficial effects of in reducing lipid peroxidation and iron overload in patients with β-thalassemia major. These antioxidants may increase the life span of RBCs, which manifested by significant increase in Hb level in vitamin E treated group and significant decrease in serum ferritin level in all treated groups.
Keywords:Beta-thalassemia, malondialdehyde, glutathione, ferritin, hematological parameters, vitamin E, L- carnitine, melatonin.