Effect of transfusional iron overload on immune response.
Increased susceptibility to infectious disease is observed in persons with transfusion-dependent thalassemia and iron overload who experience increased exposure to pathogens and chronic immune stimulation. An abnormal low CD8(+) T (LT8) immune phenotype defines a subgroup of patients. The CD8(+) T cell immunophenotype is stable despite continued blood transfusion and is independent of age. CD8(+) T cells, but not CD4(+) T cells, were modulated during intravenous chelation with deferoxamine. Return to characteristic pretreatment levels of CD8 was observed in both the low and the normal groups, suggesting the possibility of a set point. Proliferative response to mitogens and antigens was increased by chelation. Because CD8(+) T cells are important in immune response to infectious disease, these studies suggest that intrinsic CD8(+) T cell subset differences may be a critical factor in determining susceptibility to infection independent of transfusional iron overload or alloantigen exposure.
Cunningham-Rundles
S
S
Immunology, Division of Hematology/Oncology, Dept. of Pediatrics, New York-Presbyterian Hospital Cornell University Medical Center, New York, New York 10021, USA. scrundle@mail.med.cornell.edu
Giardina
P J
PJ
Grady
R W
RW
Califano
C
C
McKenzie
P
P
De Sousa
M
M
D000293:Adolescent; D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002614:Chelating Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003676:Deferoxamine / Q000627:therapeutic use*; D005260:Female; D006115:Greece / Q000208:ethnology; D006801:Humans; D016130:Immunophenotyping; D019190:Iron Overload / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D007558:Italy / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009519:New York City; D016176:T-Lymphocyte Subsets / Q000276:immunology; D065227:Transfusion Reaction; D044465:White People; D017086:beta-Thalassemia / Q000097:blood / Q000276:immunology / Q000628:therapy*
D002614:Chelating Agents; D003676:Deferoxamine