Beta-Talassemi Major Hastası Çocuklarda Toxoplasma gondii Seroprevalansı ve Bazı Bağışıklık Parametreleri Üzerindeki Etkisi

Ghufran Gubari Shannoon; Hussain A. Mhouse Alsaady; Ahmed A. Khalifa

doi:10.4274/tpd.galenos.2026.58224

ÖZ

Amaç

Majör beta-talasemi hastası çocuklarda anti-Toxoplasma gondii antikorlarının seroprevalansı henüz araştırılmamıştır. Bu çalışmada, T. gondii enfeksiyonunun hastaların bağışıklık tepkisi üzerindeki etkisi ve seçilmiş bağışıklık parametreleri, yani interlökin (IL)-10, IL-12, IL-17, interferon-gamma (IFN-γ) ile serumdaki CD4⁺ ve CD8⁺ farklılaşma kümesi belirteçlerinin konsantrasyonları arasındaki potansiyel ilişki analiz edilmiştir. Çalışma, β-talasemi majör hastası çocuklarda anti-T. gondii antikorlarının seroprevalansını ve bunun immünolojik etkisini araştırmayı amaçlamıştır.

Yöntemler

Çalışmaya 6-15 yaş aralığındaki 90 çocuk (71’i β-talasemi majör hastası, 19’u sağlıklı kontrol grubu) dahil edildi. 5 mL kan örneklerinden elde edilen serum, hızlı test, ELISA ve VIDAS yöntemleriyle anti-T. gondii immünoglobulin (Ig)G ve IgM antikorlarını saptamak için kullanılırken, sitokin düzeyleri ELISA ile ölçüldü. Serolojik testlerin ardından, katılımcı çocuklar dört gruba ayrıldı: talasemi + parazit, sadece talasemi, sadece parazit ve sağlıklı kontrol. Veriler, ki-kare ve Kruskal-Wallis testleri (p<0.05) kullanılarak analiz edildi ve sonuçlar, çalışma grupları arasında istatistiksel karşılaştırma amacıyla ortalama ± standart error olarak ifade edildi.

Bulgular

T. gondii’nin toplam seroprevalansı %30,0 (27/90) olarak saptandı; talasemi hastalarında bu oran %35,21 iken, sağlıklı kontrol grubunda %10,53 idi. Talasemi hastalarında. IgM ve IgG seropozitifliği sırasıyla %8,45 (6/71) ve %26,76 iken, kontrol grubunda bu oranlar %0,0 ve %10,53 (2/19) idi. BTM’li çocuklarda IL-10, IL-12, IL-17, CD4⁺ ve CD8⁺ düzeyleri istatistiksel olarak anlamlı derecede daha düşüktü (p<0.05), buna karşın IFN-γ (p>0.12).

Sonuç

Majör β-talasemi hastası çocuklarda, sağlıklı kontrol grubuna kıyasla T. gondii seroprevalansı istatistiksel olarak anlamlı derecede daha yüksek bulunmuştur. Enfeksiyon, bağışıklık parametrelerinde istatistiksel olarak anlamlı değişikliklerle ilişkilendirilmiş olup, bu da söz konusu hastalarda bağışıklık düzensizliğinin arttığını göstermektedir.

Anahtar Kelimeler:

Toxoplasma gondii, majör beta-talasemi, interlökinler, IFN-γ

Kaynaklar

Schultz AJ, Carruthers VB. Toxoplasma gondii LCAT primarily contributes to tachyzoite egress. mSphere. 2018; 3: e00073-18.

CrossRef PubMed Google Scholar

Dubey JP. Advances in the life cycle of Toxoplasma gondii. Int J Parasitol. 1998; 28: 1019-24.

CrossRef PubMed Google Scholar

Allamy RH, Alsaady HAM. Using antibody rapid test, RT-qPCR, and RFLP/PCR for detecting Toxoplasma gondii in the placenta of abortion women and determining the genotype in Maysan province, Iraq. J Wasit Sci Med. 2023; 16: 28-43.

CrossRef

Augusto L, Martynowicz J, Amin PH, Alakhras NS, Kaplan MH, Wek RC, et al. Toxoplasma gondii co-opts the unfolded protein response to enhance migration and dissemination of infected host cells. mBio. 2020; 11: e00915-20.

CrossRef

Al-Aubaidi IK, Saeed SA, Jaaffar AI. Blood lymphocytes detection in Iraqi diabetic type 2 patients infected with chronic toxoplasmosis by using flow cytometry. Indian J Forensic Med Toxicol. 2020; 14: 2297-303.

Alsaady HAM, Abboodı AL, Abbood ES. Sero-epidemiology of Toxoplasma gondii among men and pregnant women in Maysan Province, south of Iraq. Iran J Ichthyol. 2021; 8(Suppl 1): 27-37.

Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis. 2010; 5: 11.

CrossRef PubMed Google Scholar

Gluba-Brzózka A, Franczyk B, Rysz-Górzyńska M, Rokicki R, Koziarska-Rościszewska M, Rysz J. Pathomechanisms of immunological disturbances in β-thalassemia. Int J Mol Sci.. 2021; 22: 9677.

CrossRef PubMed Google Scholar

Shkarin VV. O sokhraniaemosti toksoplazm v konservirovannoĭ krovi donora e ee komponentakh [Survival of toxoplasma in preserved donor blood and its components]. Med Parazitol (Mosk). 1968; 37: 433-5. Russian.

Foroutan-Rad M, Majidiani H, Dalvand S, Daryani A, Kooti W, Saki J, et al. Toxoplasmosis in blood donors: a systematic review and meta-analysis. Transfus Med Rev. 2016; 30: 116-22.

Özçelik S, Alim M, Özpınar N. Detection of Toxoplasma gondii infection among diabetic patients in Turkey. Clin Epidemiol Glob Health. 2020; 8: 899-902.

CrossRef

Ehsanipour F, Faranoush P, Foroughi-Gilvaee MR, Sadighnia N, Fallahpour M, Motamedi M, et al. Evaluation of the immune system in patients with transfusion-dependent beta-thalassemia in Rasoul-e-Akram Hospital in 2021: a descriptive cross-sectional study. Health Sci Rep. 2022; 5: e871.

El-Tantawy N, Darwish A, Eissa E. Seroprevalence of Toxoplasma gondii infection among β-thalassemia major pediatric population: implications for transfusion-transmissible toxoplasmosis. Pediatr Infect Dis J. 2019; 38: 236-40.

CrossRef PubMed Google Scholar

Yousefi E, Foroutan M, Salehi R, Khademvatan S. Detection of acute and chronic toxoplasmosis amongst multi-transfused thalassemia patients in southwest of Iran. J Acute Dis. 2017; 6: 120-5.

CrossRef

Zko SS, Al-Naftachi MT, Al-Jawadi WA, Alghrer MM. Seroprevalence of Toxoplasma gondii among thalassemia patients and its relation with some biochemical parameters. J Nat Sci Biol Med. 2024; 15: 118-23.

Abd El-Latif NF, Salem AI, Sadek NA, Salah SAM, Shalaby DG, Elhadad H. Serological and molecular detection of Toxoplasma gondii in ß. thalassemia patients. J Parasit Dis. 2023; 47: 778-86.

Shihab RN, Al-Aubaidi IK. Toxoplasmosis in thalassemic Iraqi patients: serological and hematological study. Ro J Infect Dis. 2024; 27: 100-6.

Karakaş S, Ozlem S, Tellioğlu AM, Ertabaklar H, Ertuğ S. Aydın ilinde beta talasemi majorlü olgularda anti- Toxoplasma gondii IgG ve IgM antikorlarının araştırılması [Investigation of anti- Toxoplasma gondii IgG and IgM antibodies in beta-thalassemia major patients in Aydın province]. Turkiye Parazitol Derg. 2012; 36: 133-6. Turkish.

CrossRef PubMed Google Scholar

Dabirzadeh M, Yusefnia H, Azizi H, Raeghi S, Mirahmadi H. Comparison of nested PCR and ELISA techniques in diagnosis of toxoplasmosis infection in thalassemia patients by targeting the RE gene. Ann Parasitol. 2022; 68: 447-52.

CrossRef PubMed Google Scholar

Hwang S, Cobb DA, Bhadra R, Youngblood B, Khan IA. Blimp-1-mediated CD4 T cell exhaustion causes CD8 T cell dysfunction during chronic toxoplasmosis. J Exp Med. 2016; 213: 1799-818.

CrossRef PubMed Google Scholar

Ivanova DL, Krempels R, Denton SL, Fettel KD, Saltz GM, Rach D, et al. NK cells negatively regulate CD8 T cells to promote immune exhaustion and chronic Toxoplasma gondii infection. Front Cell Infect Microbiol. 2020; 10: 313.

Doherty CM, Patterson PR, Emeanuwa JA, Belmares Ortega J, Fox BA, Bzik DJ, et al. T lymphocyte-dependent IL-10 down-regulates a cytokine storm driven by Toxoplasma gondii GRA24. mBio. 2024; 15: e01455-24.

CrossRef

Moshtaghi-Kashanian GR, Gholamhoseinian A, Hoseinimoghadam A, Rajabalian S. Splenectomy changes the pattern of cytokine production in beta-thalassemic patients. Cytokine. 2006; 35: 253-7.

CrossRef PubMed Google Scholar

Sae-Khow K, Charoensappakit A, Leelahavanichkul A. Neutrophil diversity (immature, aged, and low-density neutrophils) and functional plasticity: possible impacts of iron overload in β-thalassemia. Int J Mol Sci. 2024; 25: 10651.

CrossRef PubMed Google Scholar

Hoidy WH, Chyad DH, Essa AM, Essa SM, Al-Saadi MH. Interleukin gene polymorphisms (IL-6, IL-10, IL-17 a, IL-18) predict beta-thalassemia major susceptibility and inflammatory profiles in Iraqi children: a genetic risk score analysis. Cytokine. 2026; 203: 157156.

Ruaa K. Surhan, Mayyada Darweesh, Atheer Basil Al-Obiadi. IL-10-1082A\G gene polymorphism and production in β-thalassemia major and association with HCV infection. Research J. Pharm. and Tech 2018; 11: 2603-8

Jabbar MR, Darweesh MF. Evaluate IL-10 level and gene polymorphism in β-Thalassemia patients with related to microbial infection and disease outcome. International Journal of Health Sciences. 2022; 6(S6): 5697-707.

CrossRef

Al-Taei ZKM, Jasim MM. A study of the relationship between toxoplasmosis and its effect on the level of the complete blood count and the level of interleukin 10 among aborted women in the city of Tikrit. Turk J Physiother Rehabil. 2021; 32: 14976-81.

Abdullhusein HS, Al-Aboody B, Mohammed AH, Al-Adhami RAM. The regulation of immune system by anti-inflammatory interleukins in heart disease patients infected with toxoplasmosis. Int J Res Sci Technol. 2020; 10: 16-23.

Al-Kufi AKG. Relationship between toxoplasmosis and breast cancer, and detection of some immunological and hormonal indicators in women in Al-Najaf Al-Ashraf Province [master’s thesis]. Kufa (Iraq): University of Kufa, Faculty of Education for Girls. 2020.

Ham DW, Kim SG, Seo SH, Shin JH, Lee SH, Shin EH. Chronic Toxoplasma gondii infection alleviates experimental autoimmune encephalomyelitis by the immune regulation inducing reduction in IL-17A/Th17 via upregulation of SOCS3. Neurotherapeutics. 2021; 18: 430-47.

CrossRef PubMed Google Scholar

Evangelista FF, Nishi L, Colli CM, Sant’Ana PL, Higa LT, Muniz LHG, et al. Increased levels of IL-17A in serum and amniotic fluid of pregnant women with acute toxoplasmosis. Acta Trop. 2021; 222: 106019.

CrossRef

Baqer NN, Saheb EJ, Ahmed NS. Genetic polymorphism of IL-17A (rs2275913) in Iraqi women with recurrent abortion and its relationship with susceptibility to toxoplasmosis. Meta Gene. 2021; 29: 100939.

CrossRef

Merli P, Quintarelli C, Strocchio L, Locatelli F. The role of interferon-gamma and its signaling pathway in pediatric hematological disorders. Pediatr Blood Cancer. 2021; 68: e28900.

CrossRef PubMed Google Scholar

Shihab RN. Study some biological parameters in Iraqi thalassemic patients infected with Toxoplasma gondii [dissertation]. Baghdad: University of Baghdad, College of Education for Pure Science (Ibn Al-Haitham), Department of Biology; 2024.

Ismael AK, Salih TA. Studying the role of IFN-γ, vitamin C, SOD, LH, FSH, APA and ACA in Toxoplasma gondii -infected miscarriage women. Baghdad Sci J. 2019; 16: 697-706.

CrossRef

Shihab RN, Ali Saeed S, Sulaiman EH. CD4 and CD8 T-lymphocyte cell count in β-thalassemia major patients infected with toxoplasmosis. Iran J Med Microbiol. 2025; 19: 203-9.