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BMC Pediatrics
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Assessment of peripheral blood lymphocyte subsets in children with iron deficiency anemia

Authors: Sanaa S. Aly, Hanan M. Fayed, Ahlam M. Ismail, Gehan L. Abdel Hakeem

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

Iron plays an important role in body defense and essential for normal immune system development where its deficiency may result in an inadequate immune response. We aimed to assess the lymphocyte subsets in childhood iron deficiency anemia (IDA) with their laboratory correlations.

Methods

Fifty IDA (< 18 years) and 25 age and sex-matched healthy children were enrolled and a complete history was obtained and clinical examination was performed. Complete blood count, serum iron, total iron binding capacity and serum ferritin, were performed. Flow cytometric determination of peripheral blood CD3+, CD4+, CD8+ T-lymphocytes and CD19+ B-lymphocytes and CD4/CD8 ratio were done.

Results

Patients had significantly lower hemoglobin, Serum iron, ferritin levels and higher lymphocytic count in patients compared with controls (p = 0.001, 0.03, 0.001, 0.001 respectively). CD3 count and percentage were significantly lower in IDA patients compared to controls (p = 0.007 and 0.005 respectively).
There was a Significant reduction in the CD4 count, percentage and CD4/CD8 ratio in patients compared with controls (p = 0.001, 0.001 and 0.005 respectively) while there was no significant difference regarding CD8 count and percentage. No significant difference between the two studied groups regarding either CD19 count or percentage (p = 0.28 and 0.18 respectively) were found.

Conclusions

IDA is associated with impaired cell-mediated immune response specifically T-cell mediated immunity.
Literature
1.
Andrews NC. Disorders of iron metabolism and heme synthesis. In: Greer JP, Foerster J, Rodgers GM, Paraskevas F, Glader B, Arber DA, Means RT, editors. Wintrobe’s clinical hematology. 12th ed. New York: Lippincott Williams & Wilkins; 2009. p. 818.
2.
Ward RJ, Crichton RR, Taylor DL, Della Corte L, Srai SK, Dexter DT. Iron and the immune system. J Neural Transm. 2011;118:315–28.CrossRefPubMed
3.
Weiss G. Iron, infection and anemia a classical triad. Wein Klin Wochenschr. 2000;114:357–67.
4.
Collins HL. The role of iron in infections with intracellular bacteria. Immunol Lett. 2003;133:336S–40S.
5.
Beard JL. Iron biology in immune function, muscle metabolism, and neuronal functioning. J Nutr. 2001;131:568S–80S.CrossRefPubMed
6.
Brock JH, Mulero V. Cellular and molecular aspects of iron and immune function. Proc Nutr Soc. 2000;59:537–40.CrossRefPubMed
7.
Kuvibidila SR, Porretta C. Iron deficiency and in vitro iron chelation reduce the expression of cluster of differentiation molecule CD28 but not CD3 receptors on murine thymocytes and spleen cells. Br J Nutr. 2003;90:179–89.CrossRefPubMed
8.
Abbas AK. Diseases of immunity. In: Kumar V, Abbas AK, Fausto N, editors. Robbins and Cotran pathologic basis of disease. 7th ed. Pennsylvania: Elsevier Saunders; 2005. p. 194.
9.
Bhaskaram P. Micronutrient malnutrition, infection, and immunity: an overview. Nutr Rev. 2002;60(5 Pt 2):S40–5.CrossRefPubMed
10.
Vydyborets SV. An analysis of the immunity indices of patients with iron-deficiency anemia. Lik Sprava. 2000;3:71–75.
11.
Soyano A, Gómez M. Role of iron in immunity and its relation with infections. Arch Latinoam Nutr. 1999;49(3 Suppl 2):40S–6S.PubMed
12.
Kuvibidila S, Baliga BS, Murthy KK. Impaired protein kinase C activation as one of the possible mechanisms of reduced lymphocyte proliferation in iron deficiency in mice. Am J Clin Nutr. 1991;54(5):944–50.CrossRefPubMed
13.
Omara FO, Blakley BR. The effects of iron deficiency and iron overload on cell-mediated immunity in the mouse. Br J Nutr. 1994;72:899–909.CrossRefPubMed
14.
Spear AT, Sherman AR. Iron deficiency alters DMBA-induced tumor burden and natural killer cell cytotoxicity in rats. J Nutr. 1992;122:46–55.CrossRefPubMed
15.
Grant SM, Wiesinger JA, Beard JL, Cantorna MT. Iron-deficient mice fail to develop autoimmune encephalomyelitis. J Nutr. 2003;133(8):2635–8.CrossRefPubMed
16.
Hoffbrand AV, Ganeshaguru K, Hooton JW, Tattersall MH. Effect of iron on DNA synthesis in human cells. Br J Haematol. 1976;33(4):517–26.CrossRefPubMed
17.
Lucas JJ, Szepesi A, Domenico J, Takase K, Tordai A, Terada N, et al. Effects of iron depletion on cell cycle progression in normal human T lymphocytes: selective inhibition of the appearance of the cyclin A-associated component of the p33cdk2 kinase. Blood. 1995;86(6):2268–80.PubMed
18.
Saldanha-Araujo F, Souza AM. Early effects on T lymphocyte response to iron deficiency in mice. Biol Trace Elem Res. 2009;127:95–101.CrossRefPubMed
19.
Markel TA, Crisotomo PR, Wang M, et al. The struggle for iron: gastrointestinal microbes modulate the host immune response during infection. J Leukoc Biol. 2007b;81:393–400.CrossRefPubMed
20.
Das I, Saha K, Mukhopadhyay D, Roy S, Raychaudhuri G, Chatterjee M, Mitra PK. Impact of iron deficiency anemia on cell-mediated and humoral immunity in children: a case control study. J Nat Sci Biol Med. 2014;5:158–63.CrossRefPubMedPubMedCentral
21.
Mullick S, Rusia U, Sikka M, Faridi MA. Impact of iron deficiency anemia on T lymphocytes and their subsets in children. Indian J Med Res. 2006;124:647–54.PubMed
22.
Santos PC, Falcão RP. Decreased lymphocyte subsets and K-cell activity in iron deficiency anemia. Acta Haematol. 1990;84:118–21.CrossRefPubMed
23.
Thibault H, Galan P, Selz F, Preziosi P, Olivier C, Badoual J, Hercberg S. The immune response in iron-deficient young children: effect of iron supplementation on cell-mediated immunity. Eur J Pediatr. 1993;152:120–4.CrossRefPubMed
24.
Hershko C. Iron and infection. Iron Nutr Health Dis. 1996;22:231–8.
25.
Safuanova GSH, Nikulicheva VI, Bakirov AB. Comprehensive evaluation of the immune system and various cytokines in patients with iron-deficient anemia. Klin Lab Diagn. 2004;24:33–5.
26.
Kurtoglu E, Ugur A, Baltaci AK, Mogolkoc R, Undar L. Activity of neutrophil NADPH oxidase in iron-deficient anemia. Biol Trace Elem Res. 2003;96(1–3):109–15.CrossRefPubMed
27.
Galan P, Thibault H, Preziosi P, Hercberg S. Interleukin 2 production in iron-deficient children Biol. Trace Elem. Res. 1992.32:421–426.CrossRef
28.
Mastroeni P, Vazquez-Torres A, Fang FC, Xu Y, Khan S, Hormaeche CE, et al. Antimicrobial actions of the NADPH phagocyte oxidase and inducible nitric oxide synthase in experimental Salmonellosis. II. Effects on microbial proliferation and host survival in vivo. J Exp Med. 2000;192:237–48.CrossRefPubMedPubMedCentral
29.
Nairz M, Schleicher U, Schroll A, Sonnweber T, Theurl I, Ludwiczek S, et al. Nitric oxide-mediated regulation of ferroportin-1 controls macrophage iron homeostasis and immune function in Salmonella infection. J Exp Med. 2013;210:855–73.CrossRefPubMedPubMedCentral
30.
Koskenkorva-Frank TS, Weiss G, Koppenol WH, Burckhardt S. The complex interplay of iron metabolism, reactive oxygen species, and reactive nitrogen species: insights into the potential of various iron therapies to induce oxidative and nitrosative stress. Free Radic Biol Med. 2013;65:1174–94.CrossRefPubMed
31.
Gross RL, Reid JVU, Newberne PM, Burgess B, Marston R, Hif W. Depressed cell-mediated immunity in megaloblastic anemia due to folic acid deficiency. Am J Dis Child. 1975;28:225–32.
32.
Sejas E, Kolsteren P, Hoeree T, Roberfroid D. Iron supplementation in previously anemic Bolivian children normalized hematologic parameters, but not immunologic parameters. J Trop Pediatr. 2008;54:164–8.CrossRefPubMed
33.
Reza Keramati M, Sadeghian MH, Ayatollahi H, Mahmoudi M, Khajedaluea M, Tavasolian H, et al. Peripheral blood lymphocyte subset counts in pre-menopausal women with iron-deficiency anaemia. Malays J Med Sci. 2011;18:38–44.PubMedPubMedCentral
Metadata
Title
Assessment of peripheral blood lymphocyte subsets in children with iron deficiency anemia
Authors
Sanaa S. Aly
Hanan M. Fayed
Ahlam M. Ismail
Gehan L. Abdel Hakeem
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-0990-5

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