Effect of a-thalassaemia on exercise-induced oxidative stress in sickle cell trait

Aim Alpha-thalassaemia is known to reduce intra-erythrocyte HbS (sickle haemoglobin) concentration in sickle cell trait (SCT) subjects. Because HbS was shown to increase oxidative stress, the purpose of this study was to assess the effects of the coexistence of a-thalassaemia and SCT on oxidative stress markers and nitric oxide (NO) metabolism after an acute physical exercise. Methods Forty subjects (age: 23.5 +/- 2.21 years), SCT carriers (HbAS) or healthy subjects (HbAA), with (-aT) or without (-NaT) an associated a-thalassaemia took part in the study. Plasma markers of oxidative stress [advanced oxidation protein products (AOPP), protein carbonyl, malondialdehyde (MDA) and nitrotyrosine], anti-oxidant defences and NO metabolism (NOx) were measured at rest (Trest), immediately following an incremental maximal exercise test (Tex) and during recovery (T1h, T2h and T24h). Results Malondialdehyde expressed as the percentage of changes from baseline was significantly higher in the HbAS-NaT compared with HbAS-aT during recovery (+36.3 +/- 14.1% vs. -1.8 +/- 13.2% at T1h, P = 0.02; +36.6 +/- 13.4% vs. -11.4 +/- 12.5% at T2h, P = 0.004 and +24.1 +/- 12.3% vs. -14.4 +/- 11.5% at T24h, P = 0.02 in HbAS-NaT vs. HbAS-aT). Compared with HbAS-NaT, HbAS-aT had a higher NOx change from baseline at Tex (-23.4 +/- 20.6% vs. +57.7 +/- 19.3%, respectively; P = 0.005) and lower nitrotyrosine change from baseline at T1h (+7.2 +/- 22.2% vs. +93.5%+/- 29.3%, respectively; P = 0.04). Conclusion All these data suggest that the presence of a-thalassaemia may blunt the higher level of oxidative stress and the impaired bioavailability of NO observed in the SCT carriers.