Department of Cardiovascular and Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
National Centre for the Control and Evaluation of Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
Ann Hematol. 2020 Oct;99(10):2265-2277. doi: 10.1007/s00277-020-04213-0. Epub 2020 Aug 15.
β-Thalassemia is an inherited single gene disorder related to reduced synthesis of the β-globin chain of hemoglobin. Patients with β-thalassemia present variable clinical severity ranging from asymptomatic trait to severe transfusion-dependent anemia and multiple organs complications. Moreover, multiple immune abnormalities are a major concern in β-thalassemia patients. Aberrant neutrophil effector function plays a pivotal role in infection susceptibility in these patients. In severe and persistent inflammation, immature neutrophils are released from the bone marrow and are functionally different compared with mature ones. Despite some abnormalities reported for thalassemia patient's immune system, few data exist on the characterization of human neutrophils in β-thalassemia. The aim of this study was to investigate the phenotype and function of circulating neutrophil subsets in patients with β-thalassemia major and with β-thalassemia intermedia divided in transfusion-dependent and non-transfusion-dependent. By the use of immunochemical and cytofluorimetric analyses, we observed that patients' CD16+ neutrophils exhibit abnormalities in their phenotype and functions and the abnormalities vary according to the clinical form of the disease and to the neutrophil subset (CD16 and CD16). Abnormalities include altered surface expression of the innate immune receptor CD45, Toll-like receptor 4, and CD32, reduced ability to produce an oxidative burst, and elevated levels of membrane lipid peroxidation, especially in patients with a more severe form of the disease. Overall, our results indicating the occurrence of an immuno-senescent phenotype on circulating neutrophils from thalassemia patients suggest the usefulness of neutrophil feature assessment as a tool for better clinical management of β-thalassemia.
β-地中海贫血是一种与血红蛋白β-珠蛋白合成减少相关的遗传性单基因疾病。β-地中海贫血患者的临床表现严重程度不一,从无症状携带状态到严重依赖输血的贫血和多器官并发症。此外,多种免疫异常是β-地中海贫血患者的主要关注点。异常的中性粒细胞效应功能在这些患者的感染易感性中起着关键作用。在严重和持续的炎症中,不成熟的中性粒细胞从骨髓中释放出来,其功能与成熟的中性粒细胞不同。尽管有报道称地中海贫血患者的免疫系统存在一些异常,但关于β-地中海贫血患者中性粒细胞特征的资料很少。本研究旨在研究重型和中间型β-地中海贫血患者循环中性粒细胞亚群的表型和功能,并将其分为依赖输血和非依赖输血。通过免疫化学和细胞荧光分析,我们观察到患者的 CD16+中性粒细胞在表型和功能上存在异常,并且异常的程度根据疾病的临床形式和中性粒细胞亚群(CD16 和 CD16)而有所不同。异常包括固有免疫受体 CD45、Toll 样受体 4 和 CD32 的表面表达改变、产生氧化爆发的能力降低以及膜脂质过氧化水平升高,尤其是在疾病更为严重的患者中。总之,我们的研究结果表明,地中海贫血患者循环中性粒细胞存在免疫衰老表型,提示中性粒细胞特征评估作为更好地管理β-地中海贫血的临床工具的有用性。
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