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Neutrophil apoptosis in patients with beta-thalassemia major
Hale Oren1, Bariş Sahin, Gülersu Irken
1Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey. hale.oren@deu.edu.tr
Abstract:
Increased susceptibility to infection is reported in patients with beta-thalassemia major due to toxic effect of iron on neutrophil functions and reticuloendothelial system dysfunction. This study investigated the association between the neutrophil apoptosis and frequency of infection episodes, desferrioxamine treatment, and serum ferritin levels in patients with beta-thalassemia major. A total of 35 children diagnosed with beta-thalassemia major were enrolled. Group 1 consisted patients who were receiving desferrioxamine (DFO) and group 2 consisted of patients who did not start to receive DFO. A total of 15 healthy children were enrolled to serve as a control group. Frequency of infection episodes within a year was noted from hospital records. In all patients, the same method based on flow cytometry (annexin V labeled with FITC) was used to assess neutrophil apoptosis. Neutrophil count and percentage of apoptotic neutrophils did not differ significantly between the groups. When frequency of infection episodes among groups was evaluated, frequency of infection episodes of the patients who were receiving DFO was significantly higher than in the other groups. When correlation between neutrophil apoptosis and frequency of infection episodes, serum ferritin levels, and neutrophil count of the patients was analyzed according to groups, no significant correlation was found. The results indicate that high serum ferritin level and DFO use in patients with beta-thalassemia major do not enhance neutrophil apotosis in vivo and enhanced neutrophil apoptosis cannot be a possible cause for increased susceptibility to infections in these patients.
Insights
In beta-thalassemia major patients, neither high iron levels nor desferrioxamine treatment increased neutrophil apoptosis, suggesting it doesn't cause increased infection susceptibility.
Area of Science:
- Hematology
- Immunology
- Pediatrics
Background:
- Beta-thalassemia major patients exhibit increased infection susceptibility due to iron toxicity affecting neutrophil function and the reticuloendothelial system.
- The role of neutrophil apoptosis in this increased susceptibility remains unclear.
Purpose of the Study:
- To investigate the association between neutrophil apoptosis, infection frequency, desferrioxamine (DFO) treatment, and serum ferritin levels in children with beta-thalassemia major.
Main Methods:
- Flow cytometry (Annexin V-FITC) was used to assess neutrophil apoptosis in 35 children with beta-thalassemia major and 15 healthy controls.
- Patients were divided into DFO-treated and non-DFO groups.
- Infection episode frequency was recorded from hospital records; serum ferritin and neutrophil counts were also analyzed.
Main Results:
- No significant differences in neutrophil count or apoptosis were observed between beta-thalassemia major patients and controls, or between DFO-treated and non-DFO groups.
- Patients receiving DFO had a significantly higher frequency of infection episodes compared to other groups.
- No significant correlation was found between neutrophil apoptosis and infection frequency, serum ferritin, or neutrophil count.
Conclusions:
- High serum ferritin levels and DFO use do not enhance in vivo neutrophil apoptosis in beta-thalassemia major patients.
- Enhanced neutrophil apoptosis is unlikely to be the cause of increased infection susceptibility in these patients.