Could the Crosstalk Between Myeloid-Derived-Suppressor Cells and Regulatory T Cells Have a Role in Beta-Thalassemia?

Asmaa M Zahran; Omnia El-Badawy; Eman R Badawy; Khalid I Elsayh; Eman F Gad; Khaled Saad; Khalid Hashim Mahmoud; Amira Elhoufey; Hamad Ghaleb Dailah; Marwa Ghazaly

doi:10.14740/jh1149

Could the Crosstalk Between Myeloid-Derived-Suppressor Cells and Regulatory T Cells Have a Role in Beta-Thalassemia?

J Hematol. 2023 Aug;12(4):161-169. doi: 10.14740/jh1149. Epub 2023 Aug 8.

Authors

Asmaa M Zahran¹, Omnia El-Badawy², Eman R Badawy³, Khalid I Elsayh⁴, Eman F Gad⁴, Khaled Saad^{4

5}, Khalid Hashim Mahmoud⁶, Amira Elhoufey^{7

8}, Hamad Ghaleb Dailah⁹, Marwa Ghazaly⁴

Affiliations

¹ Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
² Medical Microbiology & Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
³ Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁴ Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁵ Pediatrics Department, Assiut University Children's Hospital, Assiut, Egypt.
⁶ Department of Pediatrics, Faculty of Medicine, Shaqra University, Dawadmi, Saudi Arabia.
⁷ Department of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt.
⁸ Department of Community Health Nursing, Alddrab University College, Jazan University, Jazan, Saudi Arabia.
⁹ Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan 45142, Saudi Arabia.

Abstract

Background: Secondary iron overload, alloimmunization, and increased risk of infection are common complications in patients with transfusion-dependent thalassemia (TDT). Regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs) play an essential role in preventing excessive immune response. This research aimed to study the interaction between Tregs and MDSCs in TDT patients and to evaluate the association of these cell types with disease severity.

Methods: This case-control study included 26 patients with TDT and 23 healthy, age- and sex-matched controls. All patients were investigated for complete blood count (CBC), serum ferritin, and flow cytometric analysis of peripheral blood to detect Tregs, MDSCs, and MDSC subsets.

Results: A significant increase was observed in the frequencies of Tregs and MDSCs, particularly monocytic MDSCs (MO-MDSCs), in TDT patients compared with controls. The frequencies of these cells showed a direct association with ferritin level and total leukocyte count and an inverse association with hemoglobin level. Furthermore, a positive correlation was observed between Tregs and each of the total MDSCs and MO-MDSCs.

Conclusions: Levels of Tregs and MDSCs increased in TDT and may probably have a role in suppressing the active immune systems of TDT patients.

Keywords: Children; Myeloid-derived-suppressor cells; Regulatory T cells; β-thalassemia.