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Oxidative stress contributes to hemolysis in patients with hereditary spherocytosis and can be ameliorated by fermented papaya preparation

Annals of Hematology volume 90, pages 509–513 (2011)Cite this article

Abstract

In the present study, we questioned the role of oxidative stress in hereditary spherocytosis (HS), where red blood cells (RBC) have a shortened survival due to primary deficiency in membrane proteins. Using flow cytometry techniques, we showed that RBC derived from 17 HS patients of seven families generate more reactive oxygen species, membrane lipid peroxides, and less reduced glutathione than normal RBC. Following in vitro incubation of HS-RBC from seven patients with a fermentation bioproduct of Carica papaya (fermented papaya preparation (FPP)) with known antioxidative properties, oxidative stress markers were significantly reduced. Similar results were obtained following treatment with FPP for 3 months of 10 adult HS patients, as well as decreased tendency to undergo hemolysis. The hemoglobin levels increased by >1 g/dl, mean corpuscular hemoglobin concentration decreased by >1 g/dl, and the reticulocyte count decreased by 0.93%. Concomitantly, lactic dehydrogenase decreased by 17% and indirect bilirubin by 50%. A significant decrease in malonyldialdehyde was also detected. These data indicate that oxidative stress plays an important role in the pathophysiology of HS which can be ameliorated by an antioxidant such as FPP. Additional clinical trials with FPP and other antioxidants are warranted.

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Affiliations

  1. Department of Hematology, Edith Wolfson Medical Center, Holon, Israel

    Hussam Ghoti & Eliezer Rachmilewitz

  2. Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Eitan Fibach & Mutaz Dana

  3. Department of Hematology, Nasser Pediatric Hospital, Gaza, Palestinian Authority

    Mohammad Abu Shaban

  4. Department of Hematology, European Hospital, Gaza, Palestinian Authority

    Hussam Ghoti & Hisham Jeadi

  5. Western Galilee Hospital, Nahariya, Israel

    Andrei Braester

  6. Department of Biochemistry, Edith Wolfson Medical Center, Holon, Israel

    Zipora Matas

Authors
  1. Hussam Ghoti
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  2. Eitan Fibach
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  3. Mutaz Dana
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  4. Mohammad Abu Shaban
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  5. Hisham Jeadi
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  6. Andrei Braester
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  7. Zipora Matas
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  8. Eliezer Rachmilewitz
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Corresponding author

Correspondence to Eliezer Rachmilewitz.

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Ghoti, H., Fibach, E., Dana, M. et al. Oxidative stress contributes to hemolysis in patients with hereditary spherocytosis and can be ameliorated by fermented papaya preparation. Ann Hematol 90, 509–513 (2011). https://doi.org/10.1007/s00277-010-1110-2

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  • DOI: https://doi.org/10.1007/s00277-010-1110-2

Keywords

  • Hereditary spherocytosis
  • Oxidative stress
  • Hemolysis
  • Fermented papaya preparation (FPP)