Oxidative Stress, Antioxidant Defense and Trace Element Alterations in Sickle Cell Disease during Vaso-Occlusive Crisis and Steady State

Abstract

Background: Sickle cell disease (SCD) is associated with chronic haemolysis, inflammation and recurrent vaso-occlusive crises (VOC), with oxidative stress contributing to its pathophysiology. However, the interplay among oxidative stress, antioxidant defences and trace element status during steady state and VOC remains insufficiently characterised among Nigerian patients. Aim: This study compared oxidative stress, antioxidant defence and selected trace element parameters in SCD patients during steady state and VOC. Methodology: This comparative cross-sectional study involved 60 patients with confirmed SCD recruited at Babcock University Teaching Hospital, Ogun State, Nigeria. Participants were categorised into steady-state and crisis groups based on their clinical status. Serum vitamin C, vitamin E, zinc, iron, copper, magnesium, malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), thiamine pyrophosphate (TPP), glutathione peroxidase (GPx) and packed cell volume (PCV) were determined using standard methods. Data were analysed using Student’s t-test, Pearson’s correlation and binary logistic regression. Statistical significance was set at p < 0.05. Results: Compared with the steady-state group, patients in crisis had significantly higher MDA, GPx, iron and copper levels, but significantly lower vitamin C levels (p < 0.05). PCV was significantly lower during crisis (17.0 ± 4.8% vs. 25.35 ± 1.9%; p < 0.001). PCV correlated negatively with MDA, GPx and copper and positively with vitamin C. In logistic regression, vitamin C and MDA were independently associated with crisis status. Conclusion: VOC in SCD is associated with substantial alterations in oxidative stress and antioxidant responses, particularly increased lipid peroxidation and GPx activity alongside reduced vitamin C levels.