ABSTRACT
Objectives: Neutrophil function in hemodialysis [HD] patients are altered by iron status and patients are suspected of having defectively regulated iron metabolism. Low serum ferritin reflects absolute iron deficiency whereas normal or high ferritin values in combination with low transferrin saturation [<20%] indicate functional iron deficiency. Therefore, the aim of the present study was to investigate functional and metabolic PMNL parameters of neutrophils isolated from three different groups of regular hemodialysis patients
Patients and methods: In this study 10 healthy subjects [group I] were compared with 30 regular hemodialysis patients that were subdivided into three groups as follows: patients with serum ferritin >100 and <350 ng/ml [group II] [9patients], patients with ferritin<60 ng/m] [group III] [7 patients], and patients with ferritin >650 ng/ml but transferrin saturation <20 % [group IV] [14 patients]. Polymorphonuclear leukocyte [PMNL] parameters [phagocytosis and nitroblue-tetrazolium test [NBT] for each group was compared with healthy subjects. Both control and patient groups were studied for blood urea nitrogen, creatinine, calcium, ionized calcium, phosphorus, sodium, potassium, hemoglobin, hematocrit, serum iron and total iron-binding capacity [TIBC]. The biochemical and hematological data were obtained by routine methods using automated biochemical and hematological analyzer [Hitachi 911], [Coulter-STKS]. Serum ferritin level was done for all patients and control group using ELISA technique. Ionized calcium, sodium and potassium were measured by blood gas analyzer. Iron and TIBC were measured by using the colourmetric method. The absorption spectrum of hemoglobin was measured by using double beam spectrophotometer. The method used for measuring phagocytosis was the one which relies on the uptake of heat-killed yeast [Candida albicans] by the neutrophil over a brief period of time. Nitroblue tetrazolium [NBT] neutrophil reduction test was the test involved to determine the percentage of neutrophils showing intracytoplasmic deposits of reduced NBT [formazan]
Results: In the present study, dialyzed patients of group 11 through IV had significantly lower numbers of erythrocytes than healthy subjects. The lowest erythrocyte number was found in the functional iron deficiency patients [group IV]. Similarly, hemoglobin concentration and hematocrit levels were lower in dialysis patients than in healthy subjects. Both values were lowest in the group IV patients. The serum ferritin level was significantly lower in group III compared with group II but was very significantly higher in group IV. Serum iron was lower in all groups of hemodialysis patients compared with healthy subjects. The serum TIBC level was not significantly lower in group 11 patients. The group III had significantly increased level of TIBC compared with the control subjects. The group IV patients had a significantly lowest TIBC level within the dialysis patient groups. Significant inhibition of phagocytosis was observed in PMN L of group II and group III. However, impairment of PMNL was markedly aggravated in group IV patients with high ferritin but low transferrin saturation and low serum iron. The value of NBT-[neutrophil reduction test] as a pan of neutrophil function does not differ significantly between HD patients in all groups [group [I through group IV] and healthy subjects [group I]
Conclusion: These data suggest that iron is responsible for the PMNL dysfunction in hemodialysis patients. It is concluded that hemodialysis patients with high ferritin but low iron and low transferrin saturation [functional iron deficiency] display a significant impairment of fundamental PMNL functions
ABSTRACT
To determine the prevalence of antibodies to HTLV-1 and II among the donor population in Qatar and to evaluate the relevance of continuing routine pretransfusion screening of all donations for HTLV-I and II we surveyed all the results of the screening tests performed on 124,266 donations collected in the period August 1991 to the end of January 2004. All donations were screened by ELISA based assays and all donors who tested positive were recalled for repeat ELISA testing and confirmatory testing by Western-Blot [WB]. Two hundred and sixty nine donors tested positive for HTLV-I/HTLV-II antibodies by ELISA but only 81 donors could be retrieved for confirmatory testing. On repeat ELISA testing 27 donors gave negative reactions; the remaining 54 were still positive and were tested by WB. Of those, 22 were confirmed positive by WB, 20 were WB negative while the remaining 12 donors gave an indeterminate WB pattern. Only one of the 22 W-B confirmed positive was a Qatari national. The remaining 21 were non-Qatari donors belonging to various nationalities