Role of Quercetin Supplementation on C-reactive Protein, Tumor Necrosis Factor, and Hepcidin in Blood Transfusion-dependent Thalassemia Patients

Abstract

Background: Transfusion-dependent thalassemia (TDT) requires regular blood transfusions, leading to iron overload, oxidative stress, and inflammation, marked by elevated tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP), and altered hepcidin levels. Quercetin (QC), with its antioxidant and anti-inflammatory properties, shows promise in reducing these inflammatory markers and regulating hepcidin, potentially alleviating TDT complications. OBJECTIVE: The objective of the study was to assess the role of QC on inflammatory markers in patients with thalassemia. PATIENTS AND METHODS: The study, conducted from May to December 2023, utilized a randomized controlled trial (RCT) design to evaluate QC supplements in patients with blood TDT. Patients were randomly selected and divided into QC and placebo groups, with blood samples collected and analyzed. Results: After 3 months of supplement, the QC group showed a decrease in CRP levels and TNF-alpha levels, whereas the placebo group exhibited an increase in these levels. In addition, the hepcidin levels increased in the QC group but decreased in the placebo group, with statistically significant differences observed between the two groups (P = 0.001). Conclusion: The study shows that QC significantly impacts iron overload markers in TDT patients, reducing ferritin, CRP, TNF-alpha, and normalizing hepcidin levels.

Keywords

• inflammatory markers
• quercetin
• transfusion-dependent thalassemia