Written by Chrystal Moulton, Staff Writer. Grape seed extract supplementation with standard chelation therapy (deferasirox) significantly improved serum iron and ferritin levels while reducing inflammatory markers.
Beta-thalassemia is a hereditary hemolytic anemia with a high prevalence in the Middle East, Southeast Asia, and the Mediterranean1,2. The main treatment for beta thalassemia is blood transfusion; However, this results in high levels of iron in the body, which can play a role in pathogenesis of a variety of other diseases3. Chelation therapy is used to resolve the issue of excess iron however, the iron chelators used in therapy can cause serious side effects which in turn, limits the practice of iron chelation therapy long term4,5. Thus, it is imperative to find alternative methods to reduce excess iron in individuals suffering from beta-thalassemia. Some research has demonstrated flavonoids can ameliorate excess iron in the blood directly and indirectly6. Grape seed extract, which is rich in flavonoids, has been clinically shown to reduce free radical concentration and inflammatory markers in both in vitro and in vivo trials. In the current study, researchers investigated the safety and efficacy of grape seed extract for iron chelation in patients with beta-thalassemia7.
Transfusion-dependent beta-thalassemia patients aged 12-18 years old with ferritin levels ≥1000 ng/ml and minimum of 1-month deferasirox iron chelation therapy before intervention were included in this trial. At baseline, anthropometric and demographic data along with the clinical characteristics were collected from each patient. Patients were then randomly assigned to receive grape seed extract and deferasirox therapy or placebo and deferasirox therapy daily for four weeks. Grape seed extract capsules were provided at a dose of 100mg/day. Placebo capsules were identical but contained 100mg of starch. The participants were advised to take the assigned the protocol with or after a meal but to take the deferasirox on an empty stomach. Weekly compliance calls were conducted, and patients were asked to return any remaining capsules to calculate percent compliance. Blood samples were taken from each participant at baseline and after four weeks. The primary outcome measure was change in serum ferritin concentration. This clinical trial was designed as a randomized, double-blind, placebo-controlled study.
A total of 60 pediatric patients were enrolled at baseline. Five patients from the grape seed extract group and four from the placebo group withdrew from the study. Thus, 51 patients completed the trial (GSE n= 25, placebo n = 26). No significant differences were observed between the grape seed extract and placebo groups at baseline. The average age of patients in the grape seed extract group was 16.1 years old and in the placebo group 16.3 years old. The grape seed extract capsules were well tolerated with no serious side effects during the trial. After four weeks of grape seed extract supplementation, researchers observed significant decreases in serum level of ferritin [p = 0.017], iron [p = 0.030], malondialdehyde (MDA) [p < 0.05], TNF-alpha [p < 0.05], and C-reactive protein [p= 0.010] compared to placebo. They also observed significant increase in serum level of glutathione [p< 0.05] compared to placebo. No significant effect was observed for superoxide dismutase (SOD) nor hemoglobin between groups. Significant reduction in aspartate aminotransferase (AST) [p < 0.05] and alanine transaminase (ALT) [p < 0.05] was also observed in the grape seed extract group compared to placebo.
Overall, grape seed extract supplementation with standard chelation therapy (deferasirox) significantly improved serum iron and ferritin levels while reducing inflammatory markers in transfusion-dependent beta-thalassemia patients after 4 weeks compared to iron chelation therapy alone. These results suggest that grape seed extract may be a viable tool to support standard iron chelation therapy in patients with beta-thalassemia. More research will be needed to verify these findings.
Source: Mottaghi, Sayeh, and Hassan Abbaszadeh. “Grape seed extract in combination with deferasirox ameliorates iron overload, oxidative stress, inflammation, and liver dysfunction in beta thalassemia children.” Complementary Therapies in Clinical Practice 53 (2023): 101804.
© 2023 Elsevier Ltd. All rights reserved.
Click here to read the full text study.
Posted January 31, 2024.
Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.
References:
- Origa R. β-Thalassemia. Genet Med. Jun 2017;19(6):609-619. doi:10.1038/gim.2016.173
- Kattamis A, Forni GL, Aydinok Y, Viprakasit V. Changing patterns in the epidemiology of β-thalassemia. Eur J Haematol. Dec 2020;105(6):692-703. doi:10.1111/ejh.13512
- Shah FT, Sayani F, Trompeter S, Drasar E, Piga A. Challenges of blood transfusions in β-thalassemia. Blood Rev. Sep 2019;37:100588. doi:10.1016/j.blre.2019.100588
- Xia S, Zhang W, Huang L, Jiang H. Comparative efficacy and safety of deferoxamine, deferiprone and deferasirox on severe thalassemia: a meta-analysis of 16 randomized controlled trials. PLoS One. 2013;8(12):e82662. doi:10.1371/journal.pone.0082662
- Palumbo GA, Galimberti S, Barcellini W, et al. From Biology to Clinical Practice: Iron Chelation Therapy With Deferasirox. Front Oncol. 2021;11:752192. doi:10.3389/fonc.2021.752192
- Wang X, Li Y, Han L, Li J, Liu C, Sun C. Role of Flavonoids in the Treatment of Iron Overload. Front Cell Dev Biol. 2021;9:685364. doi:10.3389/fcell.2021.685364
- Mottaghi S, Abbaszadeh H. Grape seed extract in combination with deferasirox ameliorates iron overload, oxidative stress, inflammation, and liver dysfunction in beta thalassemia children. Complement Ther Clin Pract. Nov 2023;53:101804. doi:10.1016/j.ctcp.2023.101804
