Open Access Duman et al., J Blood Disorders Transf 2013, 4:3 DOI: 10.4172/2155-9864.1000142 Open Access Volume 4 • Issue 3 • 1000142 J Blood Disorders Transf ISSN: 2155-9864 JBDT, an open access journal The Antioxidant Effects of Capparis Ovata and Deferasirox in Patients with Thalassemia Major Handan Duman 1 , Duran Canatan 1 *, Güchan Alanoglu 2 , Recep Sutçu 3 and Tufan Nayır 4 1 Department of Pediatric Hematology, Suleyman Demirel University, Turkey 2 Department of Adult Hematology, Suleyman Demirel University, Turkey 3 Department of Biochemistry, Suleyman Demirel University, Turkey 4 Department of Public Health. Suleyman Demirel University, Turkey *Corresponding author: Duran Canatan, Department of Pediatric Hematology, Suleyman Demirel University, Turkey, E-mail: dcanatan@superonline.com Received June 07, 2013; Accepted June 27, 2013; Published June 30, 2013 Citation: Duman H, Canatan D, Alanoglu G, Sutçu R, Nayır T (2013) The Antıoxidant Effects of Capparıs Ovata and Deferasırox in Patıents wıth Thalassemia Major. J Blood Disorders Transf 4:142. doi:10.4172/2155-9864.1000142 Copyright: © 2013 Duman H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: alassemia; Antioxidants; Capparis ovata Introductıon Iron overload is one of the contributing cause of oxidative stress in thalassemic patients. As iron excesses transferrin capacity a low molecular weight iron called non-transferrin bound iron (NTBI) and its portion called labil plasma iron (LPI) occurs and causes production of oxygen-free radicals resulting in depletion of protective antioxidants. Also auto-oxidation of globin chains and premature hemolysis of red cell enhances the oxidative damage at thalassemic patients [1-3]. Oxidative stress induces apoptosis, leakage of protones from mitochondria and increases oxygen depletion causing damage to cell and organelle membranes. e long term clinical consequences of this process are hearth failure, liver fibrosis or cirrhosis and endocrinopathies e balance between the prooxidant and antioxidant levels becomes impaired while a decrease occurs in levels of antioxidant enzymes, an increase occurs in levels of MDA which is a good marker of lipid peroxidation [4]. Treatment strategies of thalassemic patients are regular transfusion and chelation therapy to main aim is to reduce iron overload and NTBI. ere are so many studies about thalassemia and the effects of antoxidants on thalassemia patients. In recent years use of specially plant origin antioxidants, such has fermented papaya preparation has been shown to reduce the oxidative stress and damage on several organs [3]. Silymarin, a flavonoid, acts as iron chelator and also increases intracellular glutathione content, suggesting to restore cellular antioxidant defences [5]. Oral vitamin E supplies an amelioration at rate of antioxidant/oxidant levels and inhibition at lipid peroxidation in patients with thalassemia [6]. Capparis, a member of Capparidacaeae family, is used in phytomedicine as anti-oxidative, hypolipidemic, anti-inflammatory and anti-hepatotoxic agent. Its the buds contain lipids, alcaloids, flavanoid and polyphenols. It is known that the antioxidant effect of capparis is formed the composition of flavanoids and polyphenols in its compund [7-10]. In a study done by Yadav et al it has been shown that capparis decidua extracts possess antihepatotoxic activity against alloxan induced hepatotoxicity and furthermore a decrease in oxidative stress has been observed [11]. Antihyperglycaemic and antioxidant effect of rutin, a polyphenolic flavonoid in normal and streptozotocin-induced diabetic Wistar rats studied. A decrease in fasting blood glucose level and an increase in insulin level observed. Additionally a decrease in lipid peroxidation products and an increase in both enzymatic and non enzymatic antioxidant levels observed [12]. It has been shown that iron chelator agents have antioxidant effect on thalassemic patients. Aſter incubation of thalassemic red cell with deferiprone it has been observed that MDA levels decreased [13]. Walter et al. [14] have been compared the antioxidant effectiveness of Abstract Iron overload and auto-oxidation of unpaired globin chains is the main cause of oxidative stress in thalassemia. We aimed to show the additive antioxidant effect of capparis and deferasirox in thalassemic patients. A total number of 40 thalassemia major patient aged between 7-30 years, who have been taken regular red cell 15 cc/kg/month to maintain Hb >10 gr/dl) and chelation (30 mg/kg/day ICL-670) for one year are involved. They were divided into two groups as control and study group randomly. Both study and control groups were followed by regular transfusion and chelation therapy. In addition study group has been taken capparis marmalade at the breakfast with a dose of a dessert-spoon (12.5 gr) younger than 10 years and a soup-spoon (25 gr) older than 10 years for 6 months. Hematological and biochemical parameters, ferritin at every month and oxidative-antioxidant status (MDA, CAT, Gpx, SOD) were measured at the beginning and at the end of the study. Serum ferritin and MDA levels declined significiantly in both groups (for ferritin; control group p=0.00; study group p=0.00) during the study but a much more decrease occured at MDA levels in the capparis given group (p=0.02). There was no statistically significant difference between the groups at the initial and last SOD CAT, GPX, SOD levels. Further more in the study group a significant decrease in liver function tests has been occured (AST p= 0.05, ALT p= 0.01). The high levels of MDA in iron overloaded thalassemic patients is the best marker of oxidative stres. Generally decreased iron burden was associated with decreased oxidant damage. In vitro it was shown that iron chelators such as deferoxamine and deferipron neutrolyse intraselluler free iron and inhibits oxidation. Our findings suggest that combination of capparis with deferasirox maybe have additive effect on decreasing the oxidative damage and hepatoxicity. Research Article Journal of Blood Disorders & Transfusion J o u r n a l o f B l o o d D i s o r d e r s & T r a n s f u s i o n ISSN: 2155-9864