Correlations between Iron Load and CD4 in Adult Transfusion-Dependent Beta Thalassemia.

IF 2.2 Q3 HEMATOLOGY Anemia Pub Date : 2021-06-17 eCollection Date: 2021-01-01 DOI:10.1155/2021/5549503
Tubagus Djumhana Atmakusuma, Ralph Girson, Sukamto Koesnoe
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Abstract

Background: Thalassemia is a hereditary disease, and severe anemia is the main phenotype of major thalassemia. Furthermore, the most important method in the management of this disease is red blood cell transfusion. Regular transfusions administered 1 or 2 times every month improve prognosis and survival. However, there is higher risk of infections and iron overload, especially in transfusion-dependent thalassemia (TDT). Infections are the second leading cause of death in adult TDT, after heart failure. Higher risk of infection is also influenced by multiple blood transfusions which causes alteration in immune response due to alloimmunization, transfusion-related infections, and iron overload. Meanwhile, iron overload in TDT alters both innate and specific immune responses. Furthermore, previous studies have shown the correlation between ferritin with CD4, but this has not been carried out in Indonesia. Therefore, this study aims to determine the correlations between iron overload (serum ferritin and transferrin saturation) and specific immune cells (CD4).

Methods: This is a cross-sectional study, and a total number of 64 subjects were examined consecutively. Chest X-ray and blood sera were obtained. The total number of subjects was 64. The seromarkers HBsAg, anti-HCV, and anti-HIV were tested using the ELISA method. Serum ferritin and transferrin saturation was tested using ECLIA, and lymphocyte subsets were analyzed using flowcytometry. Meanwhile, the correlation between variables was determined using Spearman's test.

Results: The results showed that 4.9% subjects were HBsAg positive, 10.7% were anti-HCV positive, and none were anti-HIV positive. There were 4 subjects with lung tuberculosis based on the 41 chest X-ray. Meanwhile, there was a weak negative and insignificant correlation between serum ferritin with CD4 (p=0.75; r = -0.04) and a weak positive and insignificant correlation between transferrin saturation with CD4 (p=0.133; r= 0.19).

Conclusion: There were no correlations between iron overload (ferritin) and cellular immunity (CD4) in adult transfusion-dependent thalassemia.

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成人输血依赖型β地中海贫血症患者铁负荷与 CD4 之间的相关性。
背景:地中海贫血是一种遗传性疾病,严重贫血是重型地中海贫血的主要表现型。此外,治疗这种疾病最重要的方法是输注红细胞。每月定期输血 1 至 2 次可改善预后和存活率。然而,感染和铁超载的风险较高,尤其是输血依赖型地中海贫血(TDT)患者。感染是成人地中海贫血患者的第二大死因,仅次于心力衰竭。感染风险较高还受到多次输血的影响,因为多次输血会导致同种免疫、输血相关感染和铁超载等免疫反应的改变。同时,TDT 中的铁超载会改变先天性免疫反应和特异性免疫反应。此外,以往的研究显示铁蛋白与 CD4 之间存在相关性,但这一研究尚未在印度尼西亚开展。因此,本研究旨在确定铁超载(血清铁蛋白和转铁蛋白饱和度)与特异性免疫细胞(CD4)之间的相关性:方法:这是一项横断面研究,共有 64 名受试者接受了连续检查。方法:这是一项横断面研究,共对 64 名受试者进行了连续检查,并采集了胸部 X 光片和血清。受试者总数为 64 人。采用 ELISA 方法检测血清标志物 HBsAg、抗-HCV 和抗-HIV。使用 ECLIA 检测血清铁蛋白和转铁蛋白饱和度,使用流式细胞仪分析淋巴细胞亚群。同时,使用斯皮尔曼检验确定变量之间的相关性:结果显示,4.9%的受试者为 HBsAg 阳性,10.7%为抗-HCV 阳性,无抗-HIV 阳性。根据 41 张胸部 X 光片,有 4 名受试者患有肺结核。同时,血清铁蛋白与 CD4 呈微弱负相关,不显著(p=0.75;r=-0.04),转铁蛋白饱和度与 CD4 呈微弱正相关,不显著(p=0.133;r=0.19):结论:在成人输血依赖型地中海贫血症患者中,铁过载(铁蛋白)与细胞免疫(CD4)之间没有相关性。
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来源期刊
Anemia
Anemia HEMATOLOGY-
CiteScore
4.80
自引率
3.40%
发文量
11
审稿时长
18 weeks
期刊介绍: Anemia is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all types of anemia. Articles focusing on patient care, health systems, epidemiology, and animal models will be considered, among other relevant topics. Affecting roughly one third of the world’s population, anemia is a major public health concern. The journal aims to facilitate the exchange of research addressing global health and mortality relating to anemia and associated diseases.
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