The hemolysis itself which takes place in thalassemia, is another major source of oxidative stresses.
Could lipoic acid BE preventing this hemolysis since it is an iron chelator ?
Intraerythrocytic Iron Chelation: A New Therapy for Thalassemia?
Mark D. Scott a
a Center for Immunology and Microbial Disease,
Albany Medical College, Albany, NY
Hematology, Volume 6, Issue 1 July 2001 , pages 73 - 89
Subject: Hematology;
Abstract
Thalassemic red blood cells (RBC) are characterized by
alterations in globin chain stability that result in
the release of redox-active iron within the RBC.
This iron, via a self-propagating and self-amplifying
reaction, destabilizes additional hemoglobin (hence,
releasing more iron) and causes significant oxidant
damage to other cellular components.
To attenuate this iron-mediated damage pharmacologically,
an intraerythrocytic iron chelation shuttle system is
proposed.
The iron shuttle system consists of low affinity, RBC
permeable, iron-binding agents which enter the cell, bind
iron, diffuse out, and hand-off the iron to a high affinity,
RBC-impermeable, high molecular weight starch derivative of
desferrioxamine (S-DFO).
It is proposed that interruption of the iron-dependent damage
via intraerythrocytic iron chelation results in improved RBC
survival and may obviate the need for the initiation of
transfusion therapy in some patients.
Putative shuttle agents include 2,2'-bipyridyl,
2,3-dihydroxybenzoic acid (2,3-DHB),
N,N-bis(2-hydroxybenzyl)ethylene-diamine-N,N-diacetic acid,
and pyridoxal isonico-tinoyl hydrazone.
The proposed nonpermeable terminal chelator is a high molecular
weight starch derivative of desferrioxamine that exhibits
prolonged vascular survival (up to 7 days) and very
significantly reduced toxicity relative to unmodified
desferrioxamine.
As is discussed, in vitro data demonstrate that a two component
iron shuttle system effectively slows iron-driven oxidative
damage improving the viability of model thalassemic RBC.
Further in vivo studies may prove that the intraerythrocytic
iron chelation shuttle system may have therapeutic potential
in the treatment of thalassemia.
Keywords: Thalassemia; red blood cell; iron; chelator