Telomere Length, Oxidative Stress, and Accelerated Cellular Ageing in Patients with Sickle Cell Disease in North Central Nigeria

Sickle cell disease inflicts a chronic oxidative burden on erythrocytes and systemic tissues that may accelerate cellular ageing through telomere attrition, yet this relationship has not been characterised in Nigerian HbSS patients. This study investigates leukocyte telomere length, oxidative stress markers, and their interrelationship with clinical ageing phenotypes in HbSS patients in Benue, Kogi, and Nasarawa States, North Central Nigeria. A cross-sectional multi-centre design was employed, recruiting 120 HbSS patients in steady state, 60 HbAS carriers, and 80 HbAA controls. Leukocyte telomere length was measured by quantitative real-time PCR using the relative telomere-to-single copy gene ratio method. Oxidative stress markers including 8-OHdG, malondialdehyde, isoprostanes, and total antioxidant capacity were determined. Advanced glycation end-products and p16INK4a expression in peripheral blood mononuclear cells were measured as additional cellular senescence markers. Telomere length was correlated with clinical severity indices including frequency of vaso-occlusive crises, hydroxyurea use, transfusion history, and end-organ damage markers. This study constitutes an original contribution to the geroscience of haemoglobinopathies in Africa and will develop a novel biochemical model of accelerated ageing in sickle cell disease applicable to Nigerian haematological practice. Keywords: telomere length, sickle cell disease, oxidative stress, cellular ageing, North Central Nigeria.