1 Haghpanah, S. et al. Effects of three months of treatment with vitamin E and N-acetyl cysteine on the oxidative balance in patients with transfusion-dependent β-thalassemia. Annals of hematology100, 635-644, doi:10.1007/s00277-020-04346-2 (2021).
2 Mohamed, Y. A. et al. Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major. Clinical and experimental pediatrics, doi:10.3345/cep.2020.00227 (2020).
3 Siri-Angkul, N., Chattipakorn, S. C. & Chattipakorn, N. Diagnosis and treatment of cardiac iron overload in transfusion-dependent thalassemia patients. Expert review of hematology11, 471-479, doi:10.1080/17474086.2018.1476134 (2018).
4 Ozdemir, Z. C., Koc, A., Aycicek, A. & Kocyigit, A. N-acetylcysteine supplementation reduces oxidative stress and DNA damage in children with β-thalassemia. Hemoglobin38, 359-364 (2014).
5 Pattanakuhar, S. et al. N-acetylcysteine Restored Heart Rate Variability and Prevented Serious Adverse Events in Transfusion-dependent Thalassemia Patients: a Double-blind Single Center Randomized Controlled Trial. International journal of medical sciences17, 1147 (2020).
6 Kampa, M. et al. A new automated method for the determination of the Total Antioxidant Capacity (TAC) of human plasma, based on the crocin bleaching assay. BMC clinical pathology2, 3, doi:10.1186/1472-6890-2-3 (2002).
7 Katerji, M., Filippova, M. & Duerksen-Hughes, P. Approaches and Methods to Measure Oxidative Stress in Clinical Samples: Research Applications in the Cancer Field. Oxidative medicine and cellular longevity2019, 1279250, doi:10.1155/2019/1279250 (2019).
8 Pedre, B., Barayeu, U., Ezeriņa, D. & Dick, T. P. The mechanism of action of N-acetylcysteine (NAC): The emerging role of H(2)S and sulfane sulfur species. Pharmacology & therapeutics228, 107916, doi:10.1016/j.pharmthera.2021.107916 (2021).
9 Rashidi, M. et al. Effects of Vitamin E and Zinc Supplementation on Antioxidants in Beta thalassemia major Patients. Iranian journal of pediatrics21, 8-14 (2011).
10 Hamed, E. M., Meabed, M. H., Hussein, R. R. S. & Aly, U. F. Recent insight on improving the iron chelation efficacy of deferasirox by adjuvant therapy in transfusion dependent beta thalassemia children with sluggish response. Expert opinion on drug metabolism & toxicology16, 179-193, doi:10.1080/17425255.2020.1729353 (2020).
11 Hershko, C. Pathogenesis and management of iron toxicity in thalassemia. Annals of the New York Academy of Sciences1202, 1-9, doi:10.1111/j.1749-6632.2010.05544.x (2010).
12 Allen, A. et al. Oxidative status in the β-thalassemia syndromes in Sri Lanka; a cross-sectional survey. Free Radical Biology and Medicine166, 337-347, doi:https://doi.org/10.1016/j.freeradbiomed.2021.02.028 (2021).
13 Manafikhi, H., Drummen, G., Palmery, M. & Peluso, I. Total Antioxidant Capacity in beta-thalassemia: A systematic review and meta-analysis of case-control studies. Critical reviews in oncology/hematology110, 35-42, doi:10.1016/j.critrevonc.2016.12.007 (2017).
14 Hamed, E. A. & ElMelegy, N. T. Renal functions in pediatric patients with beta-thalassemia major: relation to chelation therapy: original prospective study. Italian journal of pediatrics36, 39, doi:10.1186/1824-7288-36-39 (2010).
15 Waseem, F., Khemomal, K. A. & Sajid, R. Antioxidant status in beta thalassemia major: a single-center study. Indian journal of pathology & microbiology54, 761-763, doi:10.4103/0377-4929.91489 (2011).
16 Arman Bilir, Ö. et al. Renal function and the oxidative status among children with thalassemia major and healthy controls: A cross-sectional study. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis59, 102746, doi:10.1016/j.transci.2020.102746 (2020).
17 Bazvand, F. et al. Total Antioxidant Status in Patients with Major β-Thalassemia. Iranian journal of pediatrics21, 159-165 (2011).
18 Ondei Lde, S. et al. Oxidative stress and antioxidant status in beta-thalassemia heterozygotes. Revista brasileira de hematologia e hemoterapia35, 409-413, doi:10.5581/1516-8484.20130122 (2013).
19 Peivandi Yazdi, A. et al. Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU. Journal of intensive care medicine35, 1383-1388, doi:10.1177/0885066618823152 (2020).
20 Safe, I. P. et al. Adjunct N-Acetylcysteine Treatment in Hospitalized Patients With HIV-Associated Tuberculosis Dampens the Oxidative Stress in Peripheral Blood: Results From the RIPENACTB Study Trial. Frontiers in immunology11, 602589, doi:10.3389/fimmu.2020.602589 (2020).
21 Kumar, P. et al. Glycine and N-acetylcysteine (GlyNAC) supplementation in older adults improves glutathione deficiency, oxidative stress, mitochondrial dysfunction, inflammation, insulin resistance, endothelial dysfunction, genotoxicity, muscle strength, and cognition: Results of a pilot clinical trial. Clinical and translational medicine11, e372, doi:10.1002/ctm2.372 (2021).
22 Molnar, Z., MacKinnon, K. L., Shearer, E., Lowe, D. & Watson, I. D. The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients. Intensive care medicine24, 230-235, doi:10.1007/s001340050555 (1998).
23 Rhodes, K. & Braakhuis, A. Performance and Side Effects of Supplementation with N-Acetylcysteine: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.)47, 1619-1636, doi:10.1007/s40279-017-0677-3 (2017).
24 Trangsuwan, D. et al. Effects of Vitamin E on Transfusion Requirements in TransfusionDependent Beta-Thalassemia Patients. Journal of Health Science and Medical Research36, 225-234 (2018).
25 Sovira, N. et al. Effects of α-tocopherol on hemolysis and oxidative stress markers on red blood cells in β-thalassemia major. Clinical and experimental pediatrics63, 314-320, doi:10.3345/cep.2019.00542 (2020).
26 El-Aal, A. A., El-Ghffar, E. A. A., Ghali, A. A., Zughbur, M. R. & Sirdah, M. M. The effect of vitamin C and/or E supplementations on type 2 diabetic adult males under metformin treatment: A single-blinded randomized controlled clinical trial. Diabetes & metabolic syndrome12, 483-489, doi:10.1016/j.dsx.2018.03.013 (2018).
27 Shokrpour, M. & Asemi, Z. The Effects of Magnesium and Vitamin E Co-Supplementation on Hormonal Status and Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome. Biological trace element research191, 54-60, doi:10.1007/s12011-018-1602-9 (2019).
28 Lewis, E. D., Meydani, S. N. & Wu, D. Regulatory role of vitamin E in the immune system and inflammation. IUBMB life71, 487-494, doi:10.1002/iub.1976 (2019).
29 Dissayabutra, T., Tosukhowong, P. & Seksan, P. The benefits of vitamin C and vitamin E in children with beta-thalassemia with high oxidative stress. Journal of the Medical Association of Thailand = Chotmaihet thangphaet88 Suppl 4, S317-321 (2005).
30 Yanpanitch, O. U. et al. Treatment of β-Thalassemia/Hemoglobin E with Antioxidant Cocktails Results in Decreased Oxidative Stress, Increased Hemoglobin Concentration, and Improvement of the Hypercoagulable State. Oxidative medicine and cellular longevity2015, 537954, doi:10.1155/2015/537954 (2015).
31 Mahjoub, S., Tamadoni, A., ZANJANCHI, N. M. & Moghadamnia, A. A. The effects of beta-carotene and vitamin E on erythrocytes lipid peroxidation in beta-thalassemia patients. Journal of Research in Medical Sciences12, 301-307 (2007).
32 Bansal, D. Hepcidin and Thalassemia. Indian journal of pediatrics84, 731-732, doi:10.1007/s12098-017-2439-5 (2017).
33 Buico, A., Cassino, C., Ravera, M., Betta, P. G. & Osella, D. Oxidative stress and total antioxidant capacity in human plasma. Redox report : communications in free radical research14, 125-131, doi:10.1179/135100009x392557 (2009).
34 Allen, A. et al. Methemoglobinemia and ascorbate deficiency in hemoglobin E β thalassemia: metabolic and clinical implications. Blood120, 2939-2944 (2012).
35 Boudrahem-Addour, N. et al. Oxidative status and plasma lipid profile in β-thalassemia patients. Hemoglobin39, 36-41, doi:10.3109/03630269.2014.979997 (2015).
36 Li, S. et al. The Role of Oxidative Stress and Antioxidants in Liver Diseases. International journal of molecular sciences16, 26087-26124, doi:10.3390/ijms161125942 (2015).
37 Millea, P. J. N-acetylcysteine: multiple clinical applications. American family physician80, 265-269 (2009).
38 Das, N., Das Chowdhury, T., Chattopadhyay, A. & Datta, A. G. Attenuation of oxidative stress-induced changes in thalassemic erythrocytes by vitamin E. Polish journal of pharmacology56, 85-96 (2004).
39 Miller, L. F. & Rumack, B. H. Clinical safety of high oral doses of acetylcysteine. Seminars in oncology10, 76-85 (1983).
40 Miller, E. R., 3rd et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Annals of internal medicine142, 37-46, doi:10.7326/0003-4819-142-1-200501040-00110 (2005).
41 Sandilands, E. A. & Bateman, D. N. Adverse reactions associated with acetylcysteine. Clinical toxicology (Philadelphia, Pa.)47, 81-88, doi:10.1080/15563650802665587 (2009).
42 Moher, D., Liberati, A., Tetzlaff, J. & Altman, D. G. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine151, 264-269, w264, doi:10.7326/0003-4819-151-4-200908180-00135 (2009).
43 Higgins, J. P. et al.Cochrane handbook for systematic reviews of interventions. (John Wiley & Sons, 2019).
44 Borenstein, M., Hedges, L. V., Higgins, J. P. T., and Rothstein, H. R. Introduction to meta-analysis. Hoboken: John Wiley & Sons (2011).
45 Higgins, J. Cochrane handbook for systematic reviews of interventions. Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration. www. cochrane-handbook. org (2011).