Somdet Srichairatanakool

By Somdet Srichairatanakool, Pimpisid Koonyosying and Suthat Fucharoen

Thalassemia is an inherited disease caused by the genetic disorder of α- and β-globin genes, resulting in ineffective erythropoiesis and chronic anemia. Transfusion-dependent β-thalassemia patients require red cell transfusion to maintain their blood hemoglobin level in the normal range, whereas non-transfusion-dependent thalassemia patients increase duodenal absorption of dietary iron in an attempt to accelerate erythropoiesis. These changes give rise to iron overload, oxidative stress, organ dysfunction, and other complications. Effective iron chelators are necessary to achieve negative iron balance and to relieve such complications associated with iron overload. Some pharmaceuticals such as hydroxyurea, N-acetylcysteine, ascorbic acid, vitamin E, and glutathione are also given to thalassemia patients in order to overcome oxidative cell and tissue damage and to generate a better quality of life. Interestingly, functional natural products (such as mango, tea, caffeine, and curcumin), vegetables, and cereal (e.g., rice) are helpful for their health-providing properties by supplementing the endogenous antioxidant defensive power in the body. Natural products exhibit many pharmacological activities, but they are safer if used in the traditional manner.

Part of the book: Personalized Medicine, in Relation to Redox State, Diet and Lifestyle

By Pimpisid Koonyosying, Suthat Fucharoen and Somdet Srichairatanakool

Secondary iron overload in patients with β-thalassemia is caused by multiple blood transfusions and increased iron absorption. Most of them die from cardiac arrest and infections while others from oxidative tissue damage and organ dysfunction. Under high saturation of transferrin with iron, redox-active iron such as non-transferrin-bound iron, labile plasma iron, and cellular labile iron pool is prone to the production of reactive oxygen species, oxidized biomolecules, oxidative tissue damages, and complications. Iron chelation therapy and antioxidant supplementation are a supportive treatment for patients’ better quality of life and life expectancy. Green tea (Camellia sinensis) extract (GTE) is abundant with polyphenols, mainly epigallocatechin-3-gallate and nutraceuticals, which are beneficial for cell functions and health. Importantly, GTE possesses antioxidant, free radical scavenging, metal-chelating, anti-hemolysis properties in cell cultures, animals, and humans. This article has reported modes of actions and challenged such wonderful properties of green tea used to remove excessive iron, scavenge harmful radicals, restore malfunctions of vital organs, and treat patients with β-thalassemia with iron overload. Infeasibility and sustainability, the benefits of green tea can be applied for use in other diseases with iron toxicity and oxidative stress.

Part of the book: Beta Thalassemia