Analysis of Hepcidin and Interleukin-6 Levels among Transfusion-Dependent Thalassemia Patients With and Without Alloimmunization/Autoimmunization

Abstract

Background: Transfusion-dependent thalassemia (TDT) necessitates regular transfusions, resulting in complications such as iron overload, hemolytic anemia, and the emergence of alloantibodies/ autoantibodies. This situation poses challenges in obtaining compatible transfusions. Excessive iron and chronic hemolysis impact the elevation of Interleukin-6 (IL-6), initiating an inflammatory process that triggers hepcidin formation and influences antibody development. This study aims to analyze disparities in IL-6 and hepcidin levels and establish the correlation between IL-6 and hepcidin in TDT patients with and without alloimmunization/autoimmunization. Methods: Forty whole blood samples were collected from TDT patients with and without alloimmunization/autoimmunization, centrifuged, and the serum extracted, then stored in a refrigerator at -80°C. IL-6 and hepcidin levels were assessed using the ELISA method. The Mann-Whitney U test was employed to evaluate differences in hepcidin and IL-6 levels between the two groups. In contrast, the Spearman Correlation test was utilized to analyze the correlation between hepcidin and IL-6 levels. Results: IL-6 levels in the TDT group with alloimmunization/autoimmunization (3.64 pg/ mL) were significantly higher compared to the TDT group without alloimmunization/autoimmunization (1.41 pg/mL; p < 0.05). Hepcidin levels in the TDT group with alloimmunization/autoimmunization (2,950.6 pg/mL) were significantly higher compared to the TDT group without alloimmunization/autoimmunization (1,599.6 pg/mL; p < 0.05). The Spearman correlation test revealed a significant positive correlation between hepcidin and IL-6 levels in TDT patients with alloimmunization/autoimmunization (r = 0.764; p = 0.000). Additionally, a significant positive correlation was observed between hepcidin and IL-6 levels in TDT patients without alloimmunization/autoimmunization (r = 0.559; p = 0.010). Conclusion: IL-6 and hepcidin levels were elevated in TDT patients with alloimmunization/autoimmunization compared to those without. Interleukin-6 and hepcidin exhibited a positive correlation in both transfusion-dependent thalassemia groups.