Article · Volume 3, Issue 2S · pp. s22–s29
Supplementation of patients with sickle cell disease with astaxanthin increases plasma- and erythrocyte-astaxanthin and may improve the hemolytic component of the disease
Begoña Ruiz-Núñez1, Stéphanie A. De Rooij1, Pieter J. Offringa2, Gert E. Schuitemaker3, Tom Teerlink4, Hose S.M. Booi5, Janneke D.A. Dijck-Brouwer1, Frits A.J. Muskiet1
- 1University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, 9700 RB Groningen, The Netherlands.
- 2Sint Maarten Medical Center, Department of Pediatrics, Sint Maarten (Dutch Part).
- 3Ortho Institute, 7081 CM Gendringen, The Netherlands.
- 4VU University Medical Center, Department of Clinical Chemistry, 1081 HV Amsterdam, The Netherlands.
- 5Sint Maarten Laboratory Services, Sint Maarten (Dutch Part).
Abstract
Aim & background:Sickle cell disease (SCD) is characterized by hemolytic and vaso-occlusive compo- nents. Astaxanthin is a carotenoid of marine origin, without pro-oxidant properties.Methods: In this open label pilot study, we investigated whether orally administered astaxanthin in- corporates into erythrocytes (RBC) of SCD patients and studied the effect on hematological and clinical chemical parameters. Ten SCD patients (6e52 years) in Sint Maarten received 8e12 mg astaxanthin during 3 months.Results: Baseline plasma- (33 nmol/L) and RBC- (11 nmol/L packed RBC) astaxanthin increased to 225, 174, 167 nmol/L (plasma) and 149, 100, 71 nmol/L packed RBC at 1e3 months, respectively. Reticulocytes decreased from baseline and 2 months (9.5 and 8.8%) to 3 months (5.6%), MCV from 2 to 3 months (88 e86 fL), MCH from baseline to 3 months (30e28 pg) and RDW from baseline and 2 months (19.2 and 19.0%) to 3 months (16.7%). Plasma arginine decreased from 2 to 3 months (46.6e39.4 mmol/L). Asym- metric dimethylarginine (ADMA) did not change. Reticulocytes at baseline correlated with relative changes in reticulocytes from baseline to 3 months. Relative changes in reticulocytes correlated with relative changes in RBC, RDW, LDH, ALAT, but not hematocrit, within the same period.Conclusion: Astaxanthin incorporates into SCD RBC and may favorably affect the hemolytic component. A larger randomized controlled trial is indicated, using similar or higher dose, preferably during more than 3 months, concomitant with (other) low dose antioxidants (vitamin E, beta-carotene, vitamin C, folic acid), minerals (zinc, if necessary, selenium), arginine, fish oil and vitamin D.
Keywords: Antioxidant; Hemolytic component; Reticulocytes; Arginine; Asymmetric dimethylarginine
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