Comparative characteristics of humoral immunity indicators and their relationship with chelation therapy in thalassemia

Abstract

Introduction. Data on the increased susceptibility of patients with thalassemia to infections are of great interest to the study of various aspects of the immune status of patients.Aim. The aim of the study was to study the parameters of the humoral immunity and their relationship with chelation therapy in patients with thalassemia.Materials and methods. This study was carried out at the Republican Specialized Scientific and Practical Medical Center for Hematology from 2015 to 2020. The material of the study was the peripheral venous blood of patients with thalassemia. When determining the immunological status of patients with β-thalassemia, we examined 74 schoolchildren, aged 8–12 years. Statistical processing of clinical material was carried out using the statistical package of application programs STATISTICA 10.0.Results and discussion. The results of the study of the content of serum immunoglobulins in the blood of sick children showed a reduced synthesis of IgA (p < 0.001). At the same time, the level of IgM was significantly increased in patients with β-thalassemia, compared with the control (p < 0.001), which indicates the presence of acute inflammation in the body. Also, the results of our studies showed that there is a certain tendency to increase the level of IgG (11.2 ± 0.41 pg/ml in control versus 16.13 ± 0.58 pg/ml), there was a significant increase in the synthesis of this immunoglobulin (p < 0.001), this allows us to state about the autoimmune process. In the group of children with β-thalassemia, the level of C-reactive protein (CRP) was 4 times higher than the values of the control group (3.8 ± 0.1 ng/mg in the control versus 15.33 ± 0.17 ng/mg, p < 0.001). The level of lactoferrin in sick children was reduced by 4.2 times compared with the data of the control group. There is a dysregulation of acute phase protein factors – C-reactive protein and lactoferrin. β-thalassemia is characterized by a sharp increase in the level of pro-inflammatory cytokines – the level of IL-6 is increased by 2.9 times, and the level of IL-18 – by 8.7 times.Conclusion. The relationship between the indicators of the immune status and indicators of hemosiderosis was revealed, there is a significant difference in all the studied indicators, the use of chelation therapy contributes to positive dynamics.