N-Acetylcysteine supplementation reduces oxidative stress and DNA damage in children with β-thalassemia

Hemoglobin. 2014;38(5):359-64. doi: 10.3109/03630269.2014.951890. Epub 2014 Sep 15.


There are several reports that increased oxidative stress and DNA damage were found in β-thalassemia major (β-TM) patients. In this study, we aimed to evaluate the effects of N-acetylcysteine (NAC) and vitamin E on total oxidative stress and DNA damage in children with β-TM. Seventy-five children with transfusion-dependent β-thalassemia (β-thal) were randomly chosen to receive 10 mg/kg/day of NAC or 10 IU/kg/day of vitamin E or no supplementation; 28 healthy controls were also included in the study. Serum total oxidant status (TOS) and total antioxidant capacity (TAC) were measured, oxidative stress index (OSI) was calculated, and mononuclear DNA damage was assessed by alkaline comet assay; they were determined before treatment and after 3 months of treatment. Total oxydent status, OSI, and DNA damage levels were significantly higher and TAC levels were significantly lower in the thalassemic children than in the healthy controls (p < 0.001). In both supplemented groups, mean TOS and OSI levels were decreased; TAC and pre transfusion hemoglobin (Hb) levels were significantly increased after 3 months (p ≤ 0.002). In the NAC group, DNA damage score decreased (p = 0.001). N-Acetylcysteine and vitamin E may be effective in reducing serum oxidative stress and increase pre transfusion Hb levels in children with β-thal. N-Acetylcysteine also can reduce DNA damage.

Keywords: DNA damage; N-acetylcysteine (NAC); child; oxidative stress; vitamin E; β-Thalassemia (β-thal).

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / adverse effects
  • Acetylcysteine / therapeutic use*
  • Adolescent
  • Antioxidants / adverse effects
  • Antioxidants / therapeutic use*
  • Chelation Therapy / adverse effects
  • Child, Preschool
  • Combined Modality Therapy / adverse effects
  • Comet Assay
  • DNA Damage*
  • Dietary Supplements* / adverse effects
  • Hemoglobins / analysis
  • Humans
  • Infant
  • Iron Chelating Agents / adverse effects
  • Iron Chelating Agents / therapeutic use
  • Iron Overload / etiology
  • Iron Overload / prevention & control*
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / metabolism
  • Oxidative Stress*
  • Transfusion Reaction
  • Turkey
  • Vitamin E / adverse effects
  • Vitamin E / therapeutic use
  • beta-Thalassemia / blood
  • beta-Thalassemia / diet therapy*
  • beta-Thalassemia / drug therapy
  • beta-Thalassemia / therapy


  • Antioxidants
  • Hemoglobins
  • Iron Chelating Agents
  • Vitamin E
  • Acetylcysteine