W. Wanachiwanawin et al., Serum levels of tumor necrosis factor-alpha, interleukin-1, and interferon-gamma in beta degrees-thalassemia/HbE and their clinical significance, J INTERF CY, 19(2), 1999, pp. 105-111
Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 alph
a (IL-1 alpha), and interferon-gamma (IFN-gamma) were estimated by conventi
onal ELISA kits in 60, 42, and 58 Thai patients, respectively, with beta de
grees-thalassemia HbE and found to be above the normal range in 13%, 21%, a
nd 33% of the patients, respectively. Using high-sensitivity ELISA systems,
an additional 10 beta degrees-thal/HbE patients were compared with 9 contr
ols for concentrations of circulating TNF-alpha and IL-1 beta, and 9 and 5
patients, respectively, but only 1 and none of the controls, respectively,
showed values above the normal ranges. In patients with abnormally high IFN
-gamma levels, basal hemoglobin values were significantly lower than in tho
se with normal levels of the cytokine (mean +/- SEM: 6.03 +/- 0.24 vs. 7.08
+/- 0.18, p < 0.05), although circulating concentrations of soluble transf
errin receptors (sTrF) and absolute reticulocyte counts were similar in the
two groups. Patients with raised or normal levels of TNF-alpha, IL-1 alpha
, or IL-1 beta had similar basal hemoglobin values. In a phagocytosis assay
, monocytes of patients with raised serum levels of IFN-gamma showed signif
icantly more attached or ingested IgG-coated red cells than those of patien
ts with normal concentrations of the cytokine (mean +/- SEM: 192 +/- 22 us.
140 +/- 14 per 100 monocytes, p < 0.05). Moreover, in 3 of 4 of the former
patients, the number of attached or ingested IgG-coated red cells per 100
monocytes was above the 95% reference limit for the latter patients. The re
sults suggest that IFN-gamma aggravates the anemia of beta degrees-thal/HbE
by activating mononuclear phagocytes for destruction of red cells but not
by inhibiting erythropoiesis. The elevated serum levels of TNF-alpha and IL
-1 could contribute to complications of the disease, such as cachexia and t
hromboembolic phenomena.