Nigella sativa improves anemia, enhances immunity and relieves iron overload-induced oxidative stress as a novel promising treatment in children having beta-thalassemia major

Introduction: Thalassemias are treated by regular blood transfusions and iron chelation therapy. Iron overload-induced oxidative stress helps the pathogenesis of thalassemia-induced anemia, atherogenesis, immune suppression and tissue damage. Nigella sativa (NS) is a safe medicinal plant that has exhibited immune stimulant, antioxidant and tissue-protective effects that may benefit thalassemic patients. It is widely used in Arabic prophetic medicine Patients and methods: 25 blood transfusion-dependent children having homozygous β-thalassmia major (11 Males and 14 females ranging from 6 to 18 years) received oral NS powder (2 g/day added to foods or drinks) for 3 consecutive months. Investigations carried out for all children included evaluating: complete blood count, serum ferrtin, T cell subsets determination (CD4 and CD8), malondialdehyde (MDA) level and total antioxidant capacity (TAC). Results: NS significantly increased blood hemoglobin (from 7.50 ± 0.22–9.48 ± 0.6 g/dl) (p < 0.001), WBCs count (from 9683.33 ± 284.65–12070 ± 89 cells/cc) (p < 0.001) and neutrophils (from 3243.92 ± 168.81–4868.23 ± 387.92 cells/cc) (p < 0.001). NS enhanced cell-mediated immunity significantly via increasing CD4 counts (from 1319.88 ± 74.56–2007.64 ± 90.34 cells/ μl) (p < 0.001) and CD8 counts (from 727.09 ± 42.81–1145.31 ± 77.58 cells/μl) (p < 0.001) after NS treatment. Blood platelets and serum ferritin did not change significantly. However, iron overload-induced oxidative stress significantly decreased e.g. MDA significantly decreased (from 21.624 ± 0.31–14.864 ± 0.50 nmol/L) (p < 0.001) while TAC significantly increased (from 3.93 ± 0.11–7.69 ± 0.14 mmol/L) (p < 0.001) after NS treatment. Conclusion: NS decreased iron overload-induced oxidative stress and hemolytic anemia. NS is a promising treatment for thalassemia to potentiate therapeutic effects and alleviate side effects of iron chelation therapy. Limitations to this study included the small number of patients and the relatively short post treatment follow-up time. Future research regarding the use of NS for the treatment of thalassemia is highly recommended This clinical trial was registered in: ClinicalTrials.gov. Trial ID: NCT02816957