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. 2023 Jan 5:16:47-56.
doi: 10.2147/IJGM.S397317. eCollection 2023.

Impact of Hemin on Interleukin-21 Levels and Plasma Cells in Transfusion-Dependent Thalassemia with Positive and Negative Allo-Autoantibody

Betty Agustina Tambunan  1   2   3 , I Dewa Gede Ugrasena  3   4 , Aryati Aryati  2   3
Affiliations

Impact of Hemin on Interleukin-21 Levels and Plasma Cells in Transfusion-Dependent Thalassemia with Positive and Negative Allo-Autoantibody

Betty Agustina Tambunan et al. Int J Gen Med. .

Abstract

Introduction: Antibody formation in transfusion-dependent thalassemia is associated with chronic hemolysis and repeated transfusions. Hemolysis produces heme, which mediates B-cell differentiation into plasma cells and produces antibodies influenced by interleukin-21 (IL-21).

Objective: This study aimed to compare IL-21 levels, plasma cell percentage, and red blood cell antibodies between positive and negative allo-autoantibody thalassemia before and after hemin administration.

Materials and methods: This research employed a quasi-experimental nonequivalent control group pre-test and post-test design performed from April to November 2021 at Soetomo Academic Hospital in Surabaya, Indonesia. Heparinized blood samples of 5 mL and 4 mL and EDTA blood samples of 3 mL were taken from positive (29 patients) and negative (28 patients) allo-autoantibody thalassemia participants. Hemin 20 µM was added to 5 mL of heparinized blood, incubated for 2 hours, prepared into peripheral blood mononuclear cells (PBMCs), and cultured for 3 days. The percentage of plasma cells (CD38+CD184+) of cultured and uncultured PBMCs was measured by BD FACSCalibur Flow Cytometer. IL-21 levels of plasma and supernatants were measured with Sandwich Enzyme-Linked Immunosorbent Assay by Elabscience. Red blood cell antibodies were detected by QWALYS 3 E.M. Technology. Autoantibodies were determined by the Grifols gel tube method.

Results: IL-21 levels were significantly different in the positive and negative allo-autoantibody thalassemia groups after hemin administration. The percentage of plasma cells in the positive allo-autoantibody group increased significantly after the administration of hemin. The percentage of plasma cells between thalassemia groups was not significantly different before the hemin administration but increased significantly after it. Red blood cell antibodies after the administration of hemin were significantly different in the negative allo-autoantibody group but not significantly different in the positive allo-autoantibody group.

Conclusion: Hemin administration affected IL-21 levels, plasma cell percentage, and antibody formation in positive and negative allo-auto antibody thalassemia.

Keywords: IL-21 levels; plasma cells; red blood cells antibody; thalassemia disease.

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Conflict of interest statement

The authors declare no competing financial interests or personal relationships that could have influenced the work reported in this article.

Figures

Figure 1
Figure 1
IL-21 levels.
Figure 2
Figure 2
Percentage of plasma cells.
See this image and copyright information in PMC

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References

    1. Wahidiyat PA, Sari TT, Rahmartani LD, et al. An insight into Indonesian current thalassaemia care and challenges. ISBT Sci Ser. 2020;2020:1–8.
    1. D’Arqom A. Nucleic acid therapy for β-thalassemia. Biologics. 2020;14:95–105. doi:10.2147/BTT.S265767 - DOI - PMC - PubMed
    1. Viprakasit V, Ekwattanakit S. Clinical classification, screening and diagnosis for thalassemia. Hematol Oncol Clin North Am. 2018;32:193–211. doi:10.1016/j.hoc.2017.11.006 - DOI - PubMed
    1. Jazuli MI, Bintoro SUY, Mudjanarko SW. The association between serum ferritin levels and 25 (OH) D levels in adult patients with transfusion dependent thalassemia. J Med Chem Sci. 2022;5:35–41.
    1. Fonda T, Novida H. Management of gestational diabetes mellitus in a beta major thalassemia patient. Curr Intern Med Res Pract Surabaya J. 2021;2:45. doi:10.20473/cimrj.v2i2.26255 - DOI