Assessment of Interleukin 1-β, Interleukins -6 and Some Biochemical Parameters in a Sample of Iraqi Patients with β –Thalassemia Major
Main Article Content
Abstract
Sixty patients (male and female) with β-thalassemia major and thirty healthy subjects were enrolled in this study during their attendance at "Abin AL-Baladi Hospital in Baghdad" from September 2022 to January 2023. All patients and healthy subjects ranged in age from 15 to 30 years, and we collected the necessary data with their consent, adhering to the College of Science's ethics (CSEC/0922/0104 in 2022/9/28). Venous blood was collected and divided into two parts: the first part for the determination of CBC, and the second part was allowed to coagulate for serum separation to measure the level of C-reactive protein, ferritin, and pro-inflammatory cytokines like interleukin-1β and interleukin-6 by using the ELISA Kit. The results showed a highly significant (p≤0.01) decrease in RBC count and hemoglobin (3.03 ±0.06 106/µL and 8.01 ±0.17 Hg/dl) respectively in β-thalassemia patients in compare with control group (4.77 ±0.07 106/µL and 14.06 ±0.24 Hg/dL) respectively, while there was a highly significant (p≤0.01) increase in the platelets count (384.59 ±21.67 10^3/µL) in patients compared with control (224.06 ±6.23 10^3/µL); furthermore, ferritin and CRP showed highly significant (p≤0.01) increase (4910.15 ±202.67 ng/ml, and 3.02 ±0.08 µg/ml) respectively in patients compared with control (284.91 ±16.78 ng/ml, and 1.178 ±0.03 µg/ml) respectively. Also, there was a highly significant (P≤0.01) increase in IL-1β and IL-6, which were 284.19 ±4.29 pg/ml and 27.92 ±0.97 pg/ml, respectively, in patients in comparison with control (142.09 ±0.70 pg/ml and 11.43 ±0.32 pg/ml), respectively. From the above findings, it can be concluded that proinflammatory cytokines have a significant impact on the progression and pathology of the disease.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
licenseTerms
Publication Dates
Received
Accepted
Published Online First
References
Gaudio, A.; Morabito, N.; Catalano, A.; Rapisarda, R.; Xourafa, A.; Lasco, A. Pathogenesis of thalassemia major-associated osteoporosis: a review with insights from clinical experience. Journal of clinical research in Pediatric Endocrinology 2019 11(2), 110-117. https://doi.org/10.4274/jcrpe.galenos.2018.2018.0074.
Bajwa, H. and Basit, H. Thalassemia, 1st edition 2019. Stat Pearls Publishing: Treasure Island, FL, USA. https://doi.org/10.7759/cureus.32491.
Fraidenburg, D.R.; Machado, R.F. Pulmonary hypertension associated with thalassemia syndromes. Annals of the New York Academy of Sciences 2016, 1368 (1), 127-139. https://doi.org/10.1111/nyas.13037.
Yenzeel, J.H. The Variation in Levels of Some Male Pituitary and Gonadal Hormones in Beta-Thalassemia Major Patients in Iraq. Iraqi Journal of Science 2017, 58(1B), 216-221.
Ahmed, A.K.; Yenzeel, J. H. Determination of Some Oxidative Stress Parameters and Antioxidants in Sample of Iraqi Beta Thalassemia Major Patients. Iraqi Journal of Science 2017, 58(1A), 1-3. https://ijs.uobaghdad.edu.iq/index.php/eijs/article/view/6182.
Origa, R. β-Thalassemia. Genetics in Medicine 2017, 19(6), 609-619. https://www.nature.com/articles/gim2016173.
Mettananda, S.; Higgs, D.R. Molecular basis and genetic modifiers of thalassemia. Hematology/ Oncology Clinics 2018, 32(2), 177-191. https://doi.org/10.1016/j.hoc.2017.11.003.
Tari, K.; Valizadeh Ardalan, P.; Abbaszadehdibavar, M.; Atashi, A.; Jalili, A.; Gheidishahran, M. Thalassemia an update: molecular basis, clinical features and treatment. International Journal of Biomedicine and Public Health 2018, 1(1), 48-58. https://doi.org/10.22631/ijbmph.2018.56102.
Kosaryan, M.; Karami, H.; Darvishi-Khezri, H.; Akbarzadeh, R.; Aliasgharian, A.; Bromand, K. Treatment status of patients with B-thalassemia major in northern Iran: thalassemia registry system. Iranian Journal of Public Health 2019, 48(7), 1335.-1345. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708530.
Ćujić, D.; Stefanoska, I.; Golubović, S. Serum ferritin in healthy women and breast cancer patients. Journal of Medical Biochemistry 2011, 30(1), 33-37. https://doi.org/10.2478/v10011-010-0027-6.
Fan, K.; Gao, L.; Yan, X. Human ferritin for tumor detection and therapy. Wiley Interdisciplinary Reviews: Nanomedicine and Nanobiotechnology 2013, 5(4), 287-298. https://doi.org/10.1002/wnan.1221.
Estevão, I.F.; Peitl, J.; Bonini-Domingos, C.R. Serum ferritin and transferrin saturation levels in β0 and β+ thalassemia patients. Genetics and Molecular Research 2011, 10(2), 632-639. https://doi.org/10.4238/vol10-2gmr1016.
Nehring, S.M.; Goyal, A.; Bansal, P.; Patel, B. C. C reactive protein. In StatPearls. StatPearls Publishing, 2023. DOI: https://pubmed.ncbi.nlm.nih.gov/28722873/.
Ansar, W.; Ghosh, S. C-reactive protein and the biology of disease. Immunologic Research 2013, 56(1), 131-142. https://doi.org/10.1007/s12026-013-8384-0.
Moftah, W. M.; Mohammed, E. K.; Morsy, A.A.; Ibrahim, A.A. Ischemia Modified Albumin and C - reactive protein in Children with β-Thalassemia Major. Open Journal of Pediatrics 2020, 10(03), 452. https://www.scirp.org/journal/paperinformation?paperid=102691.
Zádor, F.; Joca, S.; Nagy-Grócz, G.; Dvorácskó, S.; Szűcs, E.; Tömböly, C.; Vécsei, L. Pro-inflammatory cytokines: potential links between the endocannabinoid system and the kynurenine pathway in depression. International Journal of Molecular Sciences 2021 22(11), 5903. https://doi.org/10.3390/ijms22115903.
D’Orazi, G.; Cordani, M.; Cirone, M. Oncogenic pathways activated by pro-inflammatory cytokines promote mutant p53 stability: Clue for novel anticancer therapies. Cellular and Molecular Life Sciences 2021, 78(5), 1853-1860. https://doi.org/10.1007/s00018-020-03677-7.
Sharma, P.; Kumar, P.; Mahapatra, T.K. An overview of cytokines; their current status and futuristic scope. Santosh University Journal of Health Sciences 2017, 3(2), 50-53. https://doi.org/10.18231/2455-1732.2017.0016.
Van Den Eeckhout, B.; Tavernier, J.; Gerlo, S. Interleukin-1 as innate mediator of T cell immunity. Frontiers in Immunology 2021, 11, 621931. https://doi.org/10.3389/fimmu.2020.621931.
Gupta, U.P.; Fucharoen, P.; Tanyong, D.I. Interleukin-1 involved in apoptosis of Beta-thalassemia/Hemoglobin E erythroid progenitor cells. Asian Journal of Medical Sciences 2012, 3(4), 8-14. https://doi.org/10.3126/ajms.v3i4.6805.
Schmidt-Arras, D.; Rose-John, S. IL-6 pathway in the liver: from physiopathology to therapy. Journal of hepatology 2016, 64(6), 1403-1415. https://doi.org/10.1016/j.jhep.2016.02.004
Tanaka, T.; Narazaki, M.; Kishimoto, T. IL-6 in inflammation, immunity, and disease. Cold Spring Harbor Perspectives in Biology 2014, 6(10), a016295. https://doi.org/10.1101/cshperspect.a016295.
Oztürk, O.; Yaylim, I.; Aydin, M.; Yilmaz, H.; Agachan, B.; Demiralp, E.; İsbir, T. Increased plasma levels of interleukin-6 and interleukin-8 in beta-thalassaemia major. Haematologia 2001, 31(3), 237-244. https://doi.org/10.1163/15685590152763782.
Motta, I.; Mancarella, M.; Marcon, A.; Vicenzi, M.; Cappellini, M.D. Management of age-associated medical complications in patients with β-thalassemia. Expert Review of Hematology 2020, 13(1), 85–94. https://doi.org/10.1080/17474086.2020.1686354.
Karim, M.F.; Ismail, M.; Hasan, A.K.M.M.; Shekhar, H.U. Hematological and biochemical status of Beta-thalassemia major patients in Bangladesh: A comparative analysis. International Journal of Hematology-Oncology and Stem Cell Research 2020, 10(1), 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818791/.
Bordbar, E.; Taghipour, M.; Zucconi, B.E. Reliability of different RBC indices and formulas in discriminating between β-thalassemia minor and other microcytic hypochromic cases. Mediterranean Journal of Hematology and Infectious Diseases 2015, 7(1). https://doi.org/10.4084%2FMJHID.2015.022.
Ribeil, J.A.; Arlet, J.B.; Dussiot, M.; Cruz Moura, I.; Courtois, G.; Hermine, O. Ineffective erythropoiesis in β-thalassemia. The Scientific World Journal 2013, 2013 (394295), 11. https://doi.org/10.1155%2F2013%2F394295.
AlAthari, R. A., and Mahdi, W. T. Investigating Some of Blood Parameters in Women with β-Thalassemia. Journal of Physics: Conference Series 2019, 1294(6), 062078. https://doi.org/10.1088/1742-6596/1294/6/062078.
Burgos, N., Cintron, D., Latortue-Albino, P., Serrano, V., Rodriguez Gutierrez, R., Faubion, S., and Hassan Murad, M. Estrogen-based hormone therapy in women with primary ovarian insufficiency: a systematic review. Endocrine 2017, 58, 413-425. https://link.springer.com/article/10.1007/s12020-017-1435-x.
Chuncharunee, S.; Archararit, N.; Leungratanamart, L.; Piyachaturawat, P. Effects of Thrombopoietic Growth Factors on Megakaryocytopoiesis in Post-splenectomized Thalassemic Patients with Thrombocytosis. Journal of Hematology and Transfusion Medicine 2017, 27(4), 423-431. https://doi.org/10.1002/9781119599586.ch.
Saad, B.H.; Abdul-AM, A. H. H.; Hussein, A.M.B.; Mazin, J.M. The study of serum ferritin level as a predictor of growth retardation in thalassemia-major. Archivos Venezolanos de Farmacologia y Terapeutica 2021, 40(5), 492-501. http://saber.ucv.ve/ojs/index.php/rev_aavft/article/view/25855.
Gombar, S.; Parihar, K.; Choudhary, M.; Gombar, S. Comparative study of serum ferritin and vitamin D in thalassemia patients with healthy controls. International Journal of Research in Medical Sciences 2018, 6(2), 693-695. https://doi.org/10.18203/2320-6012.ijrms20180322.
Jaidev, S.; Meena, V.; Sangeeta, P. Study of serum ferritin level, SGOT, SGPT and hepatitis B status in multi transfused thalassemia patients. Journal of Advance Researches in Biological Science 2011, 3(2), 63-65.
Abdulla, A.A. Evaluation of serum antioxidant enzymes in β-thalassemia major patients. International Journal of ChemTech Research 2018, 11(7), 323-328. http://dx.doi.org/10.20902/IJCTR.2018.110738.
Moftah, W.M.; Mohammed, E.K.; Morsy, A.A.; Ibrahim, A.A. Ischemia Modified Albumin and C - reactive protein in Children with β-Thalassemia Major. Open Journal of Pediatrics 2020, 10(03), 452. https://doi.org/10.4236/ojped.2020.103046.
Mehmetçik, G. Estimation of MDA, CRP and Some hematological parameters in the mature Cypriot Thalassemia patients. ZANCO Journal of Pure and Applied Sciences 2019, 31(s4), 143–149. https://doi.org/10.21271/zjpas.31.s4.23.
Kanavaki, I.; Makrythanasis, P.; Lazaropoulou, C.; Tsironi, M.; Kattamis, A.; Rombos, I.; Papassotiriou, I. Soluble endothelial adhesion molecules and inflammation markers in patients with β-thalassemia intermedia. Blood Cells, Molecules, and Diseases 2009, 43(3). https://doi.org/10.1016/j.bcmd.2009.06.002.
Kyriakou, D.; Alexandrakis, M.; Kyriakou, E.; Liapi, D.; Kourelis, T.; Passam, F.; Papadakis, A. Activated peripheral blood and endothelial cells in thalassemia patients. Annals of Hematology 2001, 80, 577-583. https://doi.org/10.1007/s002770100355.
Wanachiwanawin, W.; Wiener, E.; Siripanyaphinyo, U.; Chinprasertsuk, S.; Mawas, F.; Fucharoen, S.; Visudhiphan, S. Serum levels of tumor necrosis factor-alpha, interleukin-1, and interferon-gamma in beta-thalassemia/HbE and their clinical significance. Journal of Interferon & Cytokine Research 1999, 19(2), 105-111. https://doi.org/10.1089/107999099314243.
Sajid, H.; Bilal, A.Z.; Namoos, K.; Iqtidar, A.; Zaidi, I.A.; Asghar, A. Study of Comparison of Serum Interleukin-1 Beta Levels in Β Thalassemia Major Patients with Normal and Impaired Glucose Tolerance. Pakistan Journal of Medical & Health Sciences 2019, 13, 309-313. https://pjmhsonline.com/2019/april_june/pdf/309.pdf.
El-Rasheidy, F.H.; Essa, E.S.; Mahmoud, A.A.; Nada, A.E.W. A. Elevated serum adiponectin is related to elevated serum ferritin and interleukin-6 in β-thalassaemia major children. Journal of Pediatric Endocrinology and Metabolism 2016, 29(8), 953-958. https://doi.org/10.1515/jpem-2016-0014.
Hassan, A.M.; Rahman, S J. A. Evaluation of liver enzymes, interleukin-6 and tumer necrosis factor-alpha in children suffering from thalassemia and treated with Deferoxamine and Deferasirox drug in Kirkuk city. HIV Nursing 2022, 22(2), 1461-1465. https://hivnursing.net/index.php/hiv/article/view/581.
Aggeli, C.; Antoniades, C.; Cosma, C.; Chrysohoou, C.; Tousoulis, D.; Ladis, V.; Stefanadis, C. Endothelial dysfunction and inflammatory process in transfusion-dependent patients with beta-thalassemia major. International Journal of Cardiology 2005, 105(1), 80-84. https://doi.org/10.1016/j.ijcard.2004.12.025.