Assessment of serum fractalkine level as potential role for complications in splenectomized and non-splenectomized patients with β-thalassemia major

Abstract

Introduction: Thalassemia is a serious genetic blood related condition characterized by a lack of or malfunctioning hemoglobin in the RBCs. One of the most widespread inherited disorders is beta thalassemia (β-TM). The high susceptibility to infection in these individuals' is related to high mortality and morbidity rates. Fractalkine is known as CX3C chemokine ligand 1 (CX3CL1), which contains a total of 371 amino acid, and participates in a number of functions, including repair of tissues after injury, immunological response during inflammation, and chemotaxis effet. Methodology: A case control study, containing sixty patients recognized as suffering from β-TM, was conducted at Al Zahra Teaching Hospital, Najaf (Iraq). The patients were divided into two groups; splenectomized and non-splenectomized patients. The thalassemia disease was enrolled in the “Thalassemia Unit”. Suitable statistical techniques were used to analyze the outcomes. Results: In the current study, a significant increase in serum level of CX3CL1 was found in patients with β-TM, especially in splenectomized group (14.914 ± 2.636), (P = 0.01) and non-splenectomy (13.816 ± 2.686), (P = 0.05) group as compared with control group (12.26 ± 1.797).The linear regression analysis showed that a significant positive correlation in ferritin with serum CX3CL1 level in splenectomy patients with β-TM group. ROC curve for CX3CL1 that might be diagnosis of patients with β-TM with an AUC of 0.757 (95% CI: 0.623-0.890), sensitivity and specificity equally 75% and 83.3%.  Conclusion: Increase level of CX3CL1 due to its interaction with CX3CR1 receptor may lead to buildup of inflammatory cells in the β-TM patients, blocking CX3CL1 signaling may be helpful for patients with β-TM. Abbreviations: AUC – Area Under Curve; β-TM - Beta Thalassemia; ROC - Receiver Operating Characteristic UIBC - Unsaturated Iron-Binding Capacity test; TIBC - Total Iron-Binding Capacity Key words: Thalassemia, β thalassemia major, Fractalkine Citation: Awad AS, Ali HA, Althalmi SAA. Assessment of serum fractalkine level as potential role for complications in splenectomized and non-splenectomized patients with β-thalassemia. Anaesth. pain intensive care 2023;27(5):495−500; DOI: 10.35975/apic.v27i5.2302 Received: August 03, 2023; Reviewed: August 12, 2023; Accepted: August 14, 2023