Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2020.00227    [Accepted]
Published online November 3, 2020.
Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major
Yasmen A Mohamed1, Mohamed H Meabed1, Amany Ashraf1, Dalia S Morgan1, Mostafa G Abdul Latif1, Rehab M Abd-Elkareem2, Heba M Ahmed1 
1Department of Pediatrics, Faculty of Medicine, Beni-Suef University, Egypt
2Department of Clinical and Chemical Pathology, Faculty of Medicine, Beni-Suef University, Egypt
Correspondence: 
Heba M Ahmed, Email: heba_most@yahoo.com
Received: 15 February 2020   • Revised: 10 October 2020   • Accepted: 16 October 2020
Abstract
Background
β-Thalassemias are characterized by the presence of mutations in the globin gene that result in the absence or reduced synthesis of β-globin chains of the hemoglobin tetramer. Several studies have reported increased oxidative stress in β-thalassemia major (β-TM) patients. N-acetylcysteine (NAC), a derivative of L-cysteine amino acid, is commonly used as a mucolytic drug. Numerous studies have reported efficient antioxidant activity of NAC.
Purpose
To evaluate the effects of NAC on oxidative stress status and hemoglobin levels in children with β-TM.
Methods
This study was conducted between June and December 2019. One hundred β-TM patients were divided into two groups: 50 received NAC 10 mg/kg orally for 3 months (treatment group), while the other 50 received no treatment (non-treatment group). Total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and hemoglobin (Hb) and ferritin levels were measured and compared between groups.
Results
At the end of the study period, Hb and TAC levels were significantly higher in the treatment group than in the non-treatment group (P < .001 and .01, respectively). On the other hand, serum ferritin levels, TOS, and OSI were significantly lower (P = .004, .01, and .001, respectively) in the treatment group.
Conclusion
NAC can effectively reduce the oxidative status and increase the pre-transfusion Hb levels in children with β-TM. Furthermore, NAC could reduce iron overload in these patients.
Key Words: Total oxidative stress, N- Acetylcysteine, β - Thalassemia, Antioxidant capacity, Children


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