Journal of Blood Medicine (Feb 2022)

Effects of Iron Deficiency and Its Indicators on Lymphocyte Subsets: A Study at King Fahd Hospital of the University, Saudi Arabia

  • AlRajeh L,
  • Zaher A,
  • Alghamdi A,
  • Alsheikh R,
  • AlSultan O

Journal volume & issue
Vol. Volume 13
pp. 61 – 67

Abstract

Read online

Lolwa AlRajeh,1 Amr Zaher,1 Amal alghamdi,2 Rasha Alsheikh,2 Osama AlSultan3 1Department of Pathology, College of Medicine, Imam Abdulrahman University, Dammam, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, Imam Abdulrahman University, Dammam, Saudi Arabia; 3Internal Medicine Department, King Fahd University Hospital, Al Khobar, Saudi ArabiaCorrespondence: Lolwa AlRajeh, Email [email protected]: Iron deficiency plays an important role in our body’s immunity. Several studies have shown that it is frequently associated with infections.Objective: This study aimed to discover the effect of iron deficiency on immunity by demonstrating changes occurring in lymphocyte subsets among patients with an established diagnosis of iron deficiency.Methods: A total of 64 iron-deficient patients and 19 healthy controls were included. Complete blood counts, serum iron, ferritin, and total iron-binding capacity were assessed. Lymphocyte subsets were evaluated by flow cytometry.Results: Among iron-deficient patients, the anemic ones (Hb ≤ 11 g/dL) showed significantly lower absolute lymphocyte counts (p=0.013), lower relative and absolute NK-cell counts (p=0.025 and p=0.003, respectively), higher relative T-cell and CD4+-cell counts (p=0.026 and p=0.002, respectively). B cells and CD8+ T cells were not affected by any iron-deficiency indicators. Iron-deficient anemia patients showed a three- to fourfold increase in risk of having recurrent infections.Conclusion: Iron deficiency has an obvious effect on lymphocyte subsets. Changes in lymphocyte subsets started mainly in response to decreased hemoglobin, rather than decreased ferritin and/or iron. Synchronously decreased hemoglobin and increased total iron-binding capacity led to absolute decreases in total lymphocytes, mainly NK cells, and relative increases in T cells, mainly the helper ones. Monitoring changes in lymphocyte subsets may be helpful in identifying patients at risk of recurrent infections.Keywords: iron deficiency, lymphocyte subsets, immunity, flow cytometry

Keywords