The Effect of Iron Overload on Erythrocyte Histological Composition, Insulin-like Growth Factor, and Liver Function in Beta Thalassemia Patients

Main Article Content

Haneen G. Faisal
Khulood N. Rasheed
Mousa M. Marbut

Keywords

thalassemia, beta thalassemia major, insulin-like growth factor, ferritin, and blood smears

Abstract

This study is conducted in the College of Sciences / Department of Biology- University of Tikrit, in cooperation with the Thalassemia Center in Erbil Governorate, for the period from December 2021 - June 2022 to investigate the effect of iron overload on the histological composition of red blood cells and some physiological markers in beta thalassemia patients. A number of 120 individuals participated in this study, including 20 healthy individuals representing the control group of both sexes (11 males and 9 females) and 100 individual with beta thalassemia major who were undergoing treatment of both sexes (56 males and 44 females). Their average ages range between (3-36) years, and all disease cases have been diagnosed by specialized physicians. The results indicate through the colored blood slides that red blood cells appear generally hypochromic microcytic, as well as a discrepancy in the size and shape of red blood cells. Some of these red blood cells are large in size (macrocytosis), some in the form of a teardrop (ovalocyte), and others are target or stomatal or ghostly. It is also shown that there are significant differences in the shapes, sizes, and stains of RBCs in the blood smears of pathological cases (thalassemia) compared to the control group, but not significant when comparing males with females, except for the target cell, which has shown differences in this respect. As for the results of the analyzes of the chemical parameters GPT, GOT, ALP, the results show a significant increase in the activity of GOT, GPT and ALP enzyme in patients with beta thalassemia major compared to the control group, while there is a significant decrease in the level of IGF-1 concentration in patients with beta thalassemia major compared to the control group.

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References

1. Ibrahim, A. A. and Rasheed, K. N. (2017). Histological morphology of red blood cells and white blood cell counts of diabetic patients of both sexes. Tikrit Journal of Pure Sciences. 22(3), pp.7-16.
2. Abdulla, A. A. (2018). Evaluation of serum antioxidant enzymes in β-thalassemia major patients. International Journal of ChemTech Research, 11(7), 323-328.
3. Alkanaani, M. I., Rajab, E. R., Abdulwahed, A. M. H., Dabos, T., Alshammiri, B., Abdullah, S. N., & Al-Samarraie, M. Q. (2020). Visfatin hormone level and lipid profile in some hyperlipidemia patients in samarra city. Biochem. Cell. Arch, 20(1), 1191-1193.
4. Ali, R. J.; Ali, D. R.; Ahmed, Z. I.; Ahmed, A. A.; Hassen, D. S. and Tahir, R. M. (2020). Comparison of deferasirox and deferoxamine effect on liver enzyme activities and ferritin level in patients with beta-thalassemia. Zanco Journal of Medical Sciences (Zanco J Med Sci), 24(3), 354-359.
5. Al-Naama, L. M.; Mea’adKadhum Hassan, M. M. and Karim, A. (2020). Growth Hormone and Insulin-Like Growth Factor-1 Status in Pediatric Patients with β-Thalassemia Major. Growth, 25(9), 3183-93.
6. Ballas, S. K. (1990). The pathophysiology of hemolytic anemias. Transfusion Medicine Reviews, 4(3), 236-256.
7. Cobas, C. (2009). Cobas integra and life needs answers are trademarks of roche, roche diagnostics Ltd, Switzerland, rotkreuz. CH-6343.
8. Fadhil, S.; Abdulla, A. A. and JEBOR, M. A. (2015). Comparison of Heamatological
Parameters and Serum Eezymes in β-Thalassmia Major Patients and Healthy Controls. International Journal of Medical & Pharmaceutical Sciences, 5(6).
9. Farah, J.; Husan, A. R.; Farha, A. and Afshan, Z. W. (2013). Hyperglycemic induced variations in hematological indices in type 2 diabetics. International J. Advanced Research. 1(8): 322–334.
10. Farid, Y.; Bowman, N. S. and Lecat, P. (2019). Biochemistry, hemoglobin synthesis.
11. Farzana, Y.; Darakhshah, J. and Haleem, M.A. (2006). Serum electrolytic diabetic patient with hypertension. J. CPSP. 16(7): 445–449.
12. Franchini, R. and Massimo, N. (2006). Hereditary iron overload: Update on pathophysiology, diagnosis, and treatment. American Journal of Hematology. 81(3): 202-9.
13. Gaudio, A.; Morabito, N.; Catalano, A.; Rapisarda, R.; Xourafa, A. and Lasco, A. (2019). Pathogenesis of thalassemia major-associated osteoporosis: a review with insights from clinical experience. Journal of clinical research in Pediatric Endocrinology, 11(2), 110.
14. Holm, G. and Cherney, K. (2017). Thalassemia. Medical Reviewed by University of Illinois-Chicago, college of Medicine, Health line.
15. Isik, P.; Yarali, N.; Tavil, B.; Demirel, F.; Karacam, G. B.; Sac, R. U. et al., (2014). Endocrinopathies in Turkish children with Beta thalassemia major: results from a single center study. Pediatric hematology and oncology, 31(7): 607-615.
16. Jabbar, E. E. and Mahdi, W. T. (2022). An enzymatic and biochemical study of patients withbeta thalassemia. International Journal of Health Sciences, 6(S1), 11611–11628.
17. Jwaid, S. H. and Gata, A. M. (2020). Comparison study of major thalassemia, thalassemia intermedia of Iraqi patients and control groups for effectiveness of liver enzymes. Medico Legal Update Journal, 20(1), 1181-1184.
18. Khaleel, Z. I., Mohammed, Z. H., & AL-Samarraie, M. Q. (2019). Histological Effect of the Alcoholic Extract of Nerium Oleander in the Heart and Brain in Mice and its Effect on the Lymphocytes (In Vitro). Indian Journal of Public Health, 10(8), 2363.
19. Kassab-Chekir, A.; Laradi, S.; Ferchichi, S.; Khelil, A. H.; Feki, M.; Amri, F.; et al., (2003). Oxidant, antioxidant status and metabolic data in patients with beta-thalassemia. Clinica Chimica Acta, 338(1-2), 79-86.
20. Mahdi, A. A. H.; Kareem, A. A. and Jameel, Y. M. (2018). Evaluation of Vitamin-D3 Concentration in patients with thalassemia in Baghdad city. Diyala Journal of Medicine, 14(1): 10-19.
21. Morabito, N.; Catalano, A.; Gaudio, A.; Morini, E.; Bruno, L. M.; Basile, G.; et al., (2016). Effects of strontium ranelate on bone mass and bone turnover in women with thalassemia major-related osteoporosis. Journal of bone and mineral metabolism, 34, 540-546.
22. Muhammad, S.; Faqir, M. A.; Muhammad, I. K.; Muhammad, S. A.; Muhammad, Y. and Muhammad, S. (2013). Effect of α-lipoic acid and α-tocopherol acetate enriched broiler diet on oxidative stability and quality of broiler leg meat and meat products. Journal of Food Processing and Technology, 4(7).
23. Mukhopadhyay, D.; Saha, K.; Sengupta, M.; Mitra, S.; Datta, C. and Mitra, P. K. (2015). Role of discrimination indices in screening of Beta-Thalassemia trait in West Bengal, India: An institutional experience on 10,407 subjects. SJHS. 4(3):151- 155.
24. Nawas, S. (2011). Cobas e411 special chemistry analyzer. Obesity research center. KSU, Saudi Arabia.
25. Needham, D. and Nunn, R. S. (1990). Elastic deformation and failure of lipid bilayer membranes containing cholesterol. Biophysical journal, 58(4), 997-1009.
26. Origa, R. (2017). β-Thalassemia. Genetics in Medicine, 19(6): 609-619.
27. Rasool, M.; Malik, A.; Jabbar, U.; Begum, I.; Qazi, M. H.; Asif, M.; et al., (2016). Effect of iron overload on renal functions and oxidative stress in beta thalassemia patients. Saudi medical journal, 37(11), 1239.
28. Riza, M.; Mulatsih, S. and Triasih, R. (2019). Factors associated with insulin-like growth factor-1 in children with thalassemia major. Paediatrica Indonesiana, 59(2), 72-8.
29. Rybicki, A. C.; Qiu, J. J.; Musto, S.; Rosen, N. L.; Nagel, R. L. and Schwartz, R. S. (1993). Human erythrocyte protein 4.2 deficiency associated with hemolytic anemia and a homozygous 40glutamic acid--> lysine substitution in the cytoplasmic domain of band 3 (band 3Montefiore).
30. Shanaki, M.; Ehteram, H.; Nasiri, H.; Azad, M.; Kouhkan, F.; Pakzad, R. and Mobarra, N. (2016). Assessment of liver and kidney functional parameters along with oxidative stress and inflammatory biomarker in patients with β-thalassemia major. Iranian Journal of Pediatric Hematology and Oncology, 6(4), 249-260.
31. Sharif, Y.; Irshad, S.; Muazzam, A.; Tariq, M. H.; Kanwal, A.; Rasheed, S.; et al., (2021). Assessment of patients with β-thalassemia major, undergoing tertiary care at a regional thalassemia center in Pakistan. Pakistan Journal of Zoology, 53(1), 245.
32. Tietz, N.W. (1986). Textbook of clinical chemistry. Saunders Company.
33. Tyas, D. A.; Hartati, S.; Harjoko, A. and Ratnaningsih, T. (2020). Morphological, texture, and color feature analysis for erythrocyte classification in thalassemia cases. IEEE Access, 8, 69849-69860.
34. Walaa, A.A. (2000). A Study of Some Blood Components and Enzymes in β-Thalassaemia Major Children. Master’s thesis, College of Science, Mosul.