Blood Reduced Glutathione and Serum Transferrin Levels in Sickle Cell Anaemia

Abstract

Blood reduced glutathione (GSH) level was measured in 50 sickle cell anaemia (SCA) patients with haemoglobin SS and compared with 20 control subjects with haemoglobin AA and AS.  Other parameters compared include haemoglobin, packed cell volume (PCV), serum iron, total iron binding capacity (TIBC) and transferrin.  The effect of riboflavin supplementation was also studied in 12 of the SCA subjects.  Haemoglobin, PCV, serum iron, TIBC, as well as percentage saturation of transferrin values were all significantly lower (P<0.05) in the SCA patients than in the control subjects.  However the mean erythrocyte haemoglobin concentration (MEHC) value of 34.7 ± 4.0% recorded for the SCA group did not suggest an anaemia that required iron therapy.  There was a significant positive correlation between TIBC and serum iron levels in both the control and the SCA group, (r = 0.48, P<0.001, and r = 0.53, P<0.05, respectively).  Transferrin saturation was significantly associated with haemoglobin level in the control but not in the SCA group(r = 0.479.P<0.05, n = 20 and r = 0.011, P>0.05, n = 50 respectively).  However, GSH level was positively related to haemoglobin in both groups but only significantly so in the SCA patients, (r = 0.462, P<0.05, n = 50), while MEHC was also significantly associated with GSH in only the SCA group, (r = 0.591, P<0.05).  The iron status but not the haemoglobin level of the SCA patients was significantly improved by the riboflavin supplementation.  The GSH level increased only slightly in the supplemented but decreased significantly in the supplemented group during the study period.  The reduced GSH and transferrin levels in the SCA group compromised their antioxidant status, increased oxidant stress in these patients contributing in part to the haemolytic anaemia associated with this disease.  The protective function of GSH in red blood cell, the factors accounting for increased oxidant stress in SCA patients and the consequent decrease in blood GSH level observed in these patients are discussed.  A closer look at the possibility of raising haemoglobin concentration and blood GSH through administration of riboflavin in the management of SCA is recommended.