The Clinical Effects of Fermented Papaya PreparationR (FPPR) on Oxidative Stress in Patients with HbE/ β -Thalassaemia

1 Saumya Shekhar Jamuar, 2 Ee Shien Tan, 2 Li Sun, 3 Hai Yang Law, 4 Angeline HM Lai, 5 Ivy SL Ngn

(1) Genetics Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
(2) Department of Renal Medicine, Singapore General Hospital, Singapore

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Background: Red blood cells (RBC) of patients with thalassaemia are under continuous oxidative stress.ermented papaya preparationR (FPPR) has been shown to have an antioxidative effect and is postulated to reduce the oxidative stress on RBC.

Objective: To study the clinical effects of FPPR treatment in patients with HbE/β-thalassaemia on RBC indices, oxidative stress and quality of life scores.

Method: Patients with HbE/β-thalassaemia who do not receive regular blood transfusion were included in the study and were given FPPR daily (3gm 2 times a day) for 12 weeks. Peripheral blood samples were obtained at the initiation of the study and at 4-weekly intervals thereafter for a period of 12 weeks. The following parameters were measured:

1. Haemoglobin (Hb), mean corpuscular volume (MCV), reticulocyte count;

2. Oxidation studies: production of reactive oxygen species (ROS) and intracellular glutathione content (GSH), spontaneously and in response to oxidative stress;

3. Quality of life (QoL) at the start and at the end of 12 weeks using health survey questionnaires.

Results: Seven patients (5 females and 2 males) were recruited to the study from January 2006 to April 2006. Median age of the study population was 19 years (range 4 to 27yrs). In vitro analyses showed production of significantly less ROS and more GSH following treatment. There was no significant difference in the Hb, MCV, reticulocyte count, clinical parameters or QoL scores. FPPR was well tolerated by all the patients.

Conclusion: Although oxidative stress parameters were decreased, FPPR did not have any significant effect on the Hb levels or QoL. Longer studies on larger sample size are required to study the long-term clinical effect of FPPR on clinical parameters in patients with Hb E/β-thalassaemia.

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