الفهرس 
Literature ReviewOnly 14 pages are availabe for public view
 |  | from | 241 |  |  |
| | | from | 241 | | |
Abstract
Hepatitis C virus (HCV) infection is the most frequent cause of hepatitis in children with transfusion-dependent thalassemia, which frequently progresses towards chronic active hepatitis and cirrhosis. Infectious complications constitute the second most common cause of mortality and a main cause of morbidity among β-thalassemic major (βTM) patients. Furthermore, several immunological defects have been reported in patients with βTM. So, the present study has been designed to evaluate the immune status of thalassemic patients with chronic hepatitis C (CHC) infection by enumerate the percentages of ”CD3-CD56+” NK, ”CD3+CD56+” NKT, ”CD4+” and ”CD8+ cells ” and measurement the serum levels of IFN - γ and IL-15 in these patients.
This study included four subjects: (1) Thirty five β-thalassemic patients with CHC virus infection (βTH/CHC), (2) Fifteen β-thalassemic patients without HCV infection (βTH), (3)Ten patients with CHC virus infection (CHC) (4) Fifteen healthy individuals as normal controls (NC).
The percentages of CD3-CD56+NK cells showed a highly significant (p<0.01) decrease in [βTH/CHC (3.38±1.39), βTH (8.41±2.48), CHC (5.92±2.48)] patients when compared with normal controls (12.07±2.55).While, the percentages of CD3+CD56+NKT cells showed a highly significant (p<0.01) decrease in βTH/CHC (2.46±1.16) patients when compared to normal controls (4.01±2.28) and no significant differences between βTH (3.216±2.081) and CHC (2.93±0.54) patients, when compared with normal controls. These results indicate that a defective cellular innate immune response in those patients CD4+ cells percentages showed a highly significant (p<0.01) reduction in [βTH/CHC (23.3±10.85), βTH (32.16±5.71) patients and CHC patients (31.25±9.44] when compared with normal controls (42.61±2.63), these percentages in βTH/CHC patients also showed a highly significant (p<0.01) reduction than those of βTH patients and a significant (p<0.05) reduction when compared to CHC patients.
The proportions of CD8+ cells indicated that there were a highly significant (p<0.01) reduction in βTH/CHC patients (22.4±6.39) than those of βTH (27.89±6.29) and a highly significant (p<0.01) increase in βTH when compared with normal controls (21.66±2.57). The depression in the number of these cells indicated that the virus overcome the host defense, which lead to the persistence of HCV infection.
The results of CD4+: CD8+ ratio appeared a highly significant (p<0.01) decrease in all patients [βTH/CHC (1.029±0.377), βTH (1.228±0.424), CHC (1.227±0.427)] when compared with normal controls (1.993±0.263).These results elucidated that the adaptive immune response is depressed in these patients.
The findings of serum levels indicated that human IFN-γ serum levels were highly significantly (p<0.01) elevated in CHC patients (6.89±3.45) than those of βTH/CHC patients, βTH patients and normal controls [(2.57±0.340) ;( 3.03±0.373); (4.73±1.17), respectively]. These findings also showed that there were highly significantly (p<0.01) depression in thalassemic patients [βTH/CHC; βTH] when compared with normal controls.
The serum levels of human IL-15 showed a highly significant (p<0.01) elevation in [βTH/CHC (38.04±27.18); CHC (35.17±22.27)] patients than normal controls (6.46±3.66), also a highly significant increase in βTH/CHC patients than βTH patients (16.22±11.24).
CD3- CD56+NK and CD4+ cells showed a highly significant (p<0.01) reduction in splenectomised(S) patients than non-splenectomised (NS). Also the percentage of CD8+ cells were significantly (p<0.05) reduced in S patients than NS ones. These results suggested the importance of spleen as a reservoir and its role in regulation of immune cells.
CD3-CD56+NK cells, CD3+CD56+ NKT cells and CD4+:CD8+ ratio showed a highly significant (p<0.01) decrease in (PCR +) patients than (PCR –) ones. These results reflected the negative relation of innate and adaptive immune response cells and viral replication.
Finally, a highly (p<0.01) inverse correlation between CD4+:CD8+ ratio versus the numbers of frequent blood transfusion in βTH/CHC was detected. These results suggested that blood transfusion modulated the host immune response in those patients.