Oxidative stress markers and disease severity among children with Sickle Cell Anaemia

Background: Sickle cell anaemia has been associated with oxidative stress. Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) are cumulative markers of oxidative stress.Objective: To evaluate the serum levels of oxidative stress markers in children with sickle cell anaemia (SCA) and determine the relationship between these markers and disease severity.Method: One hundred and fifty-six children, comprising 78 with SCA, aged 1 - 15 years and 78 age- and sex-matched Haemoglobin AA controls were studied. Serum TOS, OSI, and TAC were determined using ELISA kits. The severity of the SCA was determined using clinical and laboratory parameters.Result: Children with SCA had lower mean serum TAC (0.83±0.31UAE) than controls (1.19±0.24UAE) with p<0.001. However, the mean serum TOS and OSI of children with SCA was higher than among the controls (13.33±4.64U/ml vs. 9.70±2.72U/ml and 20.95±16.75 vs. 8.68±3.76 respectively) with p<0.001. SCA subjects with mild disease had higher mean serum TAC (0.91 ± 0.27UAE) than those with moderate disease (0.54±0.27UAE) (p<0.001). On the other hand, the mean TOS and OSI were lower in children with mild disease compared to those with moderate disease (12.64±4.32U/ml vs. 15.63±5.07U/ml, p = 0.016 and 16.26±10.25 vs. 36.61±23.89 p<0.001 respectively). Sickle cell disease severity score had negative correlation with TAC (r = -0.60, p < 0.001) but positive correlation with TOS (r = 0.3, p = 0.008) and OSI (r = 0.6, p < 0.001).Conclusion: Children with SCA had lower TAC but higher TOS and OSI than matched controls. Oxidative stress markers had a significant relationship with SCD severity.