Lipid peroxidation and rhesus D genotying in sickle cell patients at Mulago Hospital

Abstract

Sickle cell disease is a hereditary disorder associated with increased oxidative stress. Sickle cell disease patients frequently receive red blood cell (RBC) transfusions and RBC alloimmunisation remains a significant problem particularly to those who require chronic transfusion therapy that further increase the rate of breakdown of the sickle red blood cells resulting in increased anemia. However, there is little information on the prevention of RBC alloimmunisation and relationship between malondialdehyde (MDA) levels and rhesus D gene (RhD) types in sickle cell patients. A study was conducted with the aim of evaluating MDA levels and RhD gene diversity in sickle cell patients. MDA was determined by thiobarbituric acid assay and RhD gene diversity by allele specific polymerase chain reaction (PCR). Out of 30 blood samples from the sickle cell clinic, Mulago hospital, 40% (n=12) were confirmed Rh D negative and 28% (n=8) were confirmed Rh D positive. All the blood samples from blood bank, 16.7% (n=5) were confirmed Rh D positive. Levels of MDA, an oxidative stress biomarker was determined for each sickle cell status and Rh D genotypes using both plasma and lysates. The participants who were Rh D negative had higher mean level of MDA (2.09±0.04nM) compared to those who were Rh D positive (1.89±0.01nM). The mean level of MDA significantly higher in Sickle cell patients (SS) (2.14±0.02nM) compared to sickle cell carrier patients (AS) (1.89±0.01nM) and the normal participants (AA) (1.59±0.03nM) participants. The females had low levels of MDA (2.13±0.02) as compared to male participants (2.24±0.06) Therefore can be concluded that there if an increased oxidative stress in SCD patients who are Rh D negative compared to SCD patients who are Rh D positive and homozygous SCD patients show higher oxidative stress compared to AS and AA participants with males being more affected than females.