Crosstalk between cytokine profile, redox, and iron status in β-Thalassemia: relation to frequency/duration of blood transfusion

Abstract

β-Thalassemia, a blood disease instigated by mutations in β-globin genes or their regulatory regions. Infectious complications, immune abnormalities and iron overload related organ damage are the chief causes of morbidity and mortality. The role of inflammatory cytokines in the pathophysiology of β-thalassemia is still indistinct, so the present study aimed to evaluate immune-inflammatory and redox status in β-thalassemia and their relation to iron status, frequency/duration of blood transfusion. Seventy β-Thalassemia patients (35 β-thalassemia major; 35 β-thalassemia intermedia) and twenty age and sex-matched healthy controls were included. Interleukin4 (IL4), Interleukin10 (IL10), Interleukin 8 (IL8), and Interleukin 13 (IL13) levels were immunoassayed in addition to iron, hematological and redox status assessment. Significantly increased iron, ferritin, IL8, IL13 levels (p value ˂0.001), meanwhile, decreased IL10 level, total anti-oxidant (TAC) and iron binding capacities were observed in β-thalassemia major compared with β-thalassemia intermedia and control groups (p value ˂0.001) . IL4 level was decreased in patients group compared to control. Positive correlation was found between malondialdehyde (MDA), IL8, IL13 and iron load, transfusion frequency/duration, total leucocyte count and lymphocyte (%). Meanwhile, negative correlation was found with IL4, IL10, and TAC. Multiple blood transfusions increased iron stores which may critically impair the immune-regulatory balance with disturbed redox status and cytokine profile.

Keywords:

• β-thalassemia major
• cytokines
• IL4
• IL8
• IL10
• IL13
• iron over load
• redox status

Authors’ contributions

WAK researched literature and conceived the study, performed laboratory work, and wrote the first draft paper. NMH, was involved in protocol development, gaining ethical approval, patient recruitment, and data analysis. NEE and SAA, were involved in protocol development, patient recruitment, and data analysis. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Competing interests

The authors declare that they have no competing interests.

Ethical approval and consent to participate

The Ethical Committee of Tanta Faculty of Medicine approved this study (32051).

Acknowledgments

The authors would like to thank all participant and their parents, nurse practitioners who acquired specimens and hospital lab technical assistance. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.