The Effect of Iron Deficiency on Immune Parameters, Including Memory B Cells and Infection Presentations: A Cohort Study in Premenopausal Women

Yıl 2025, Cilt: 35 Sayı: 6, 1165 - 1177, 31.12.2025

Tuğba Önalan , Fatih Çölkesen , Mehmet Emin Gerek , Fatma Arzu Akkuş , Recep Evcen , Mehmet Kılınç , Filiz Sadi Aykan , Şevket Arslan

https://doi.org/10.54005/geneltip.1694683

Öz

Background: Iron deficiency anemia (IDA) is a condition associated with increased susceptibility to infections in the general population and more common in premenopausal women (PW). Clinical research focussing on humoral immunity and immune memory is limited in contrast to laboratory research.
Objective: This study aims to explore the effects of iron deficiency (ID) and IDA on immune function in PW by assessing immunoglobulins, lymphocyte subsets, memory B cell (MBC) quantities, and infection presentations.
Methods: A total of 180 PW who presented to the immunology outpatient clinic of a tertiary referral center between 2017 and 2024 were included. Infection history data were collected during routine clinical interviews using a six-question screening form designed to identify frequent or severe infections. Patient responses were verified through prescriptions, radiological reports, or physician documentation retrieved from the national health database. Measured parameters included haemoglobin, ferritin, immunoglobulins (IgG, A, M) and IgG subclasses, lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, CD16+56+), and MBCs (CD19+CD27+IgM−IgD−). Subjects were categorized into three groups: IDA, ID, and a control group with normal haemoglobin and ferritin levels.
Results: Total lymphocyte and Natural Killer (NK) cell counts, percentage of MBCs in B lymphocytes and IgG levels were significantly lower in the IDA compared to control group. For MBC and IgG1, IDA had lower levels than both groups. Recurrent pneumonia was a more frequent infection presentation in the IDA compared to control group.
Conclusions: In PW with IDA, reductions in lymphocytes, NKs, IgG, IgG1, and MBCs, along with the higher frequency of recurrent pneumonia, may indicate a reduced capacity of immune responses against pathogens. Given the role of MBCs in maintaining long-term, even lifelong immune responses to infections or vaccinations, the potential relationship between IDA and MBC levels may represent an important and open area for further investigation regarding the sustainability of long-term immunity.

Anahtar Kelimeler

Iron deficiency anemia , premenopause , humoral immunity , memory B cells , lymphocyte subsets , immunoglobulins

Demir Eksikliğinin Bağışıklık Parametreleri, Bellek B Hücreleri ve Enfeksiyon Bulguları Üzerine Etkisi: Premenopozal Kadınlarda Bir Kohort Çalışması

Öz

Giriş: Demir eksikliği anemisi (DEA), genel toplumda enfeksiyon sıklığındaki artışla ilişkilendirilen bir durumdur ve premenopozal kadınlarda daha sık görülmektedir. Humoral immünite ve immün hafıza üzerine yapılan klinik araştırmalar, laboratuvar temelli çalışmalara kıyasla sınırlıdır.
Amaç: Bu çalışmada, premenopozal kadınlarda demir eksikliği (DE) ve DEA'nın immün yanıt üzerindeki etkileri; immünoglobulin düzeyleri, lenfosit alt grupları, bellek B hücresi (BBH) miktarları ve enfeksiyon öyküsü açısından değerlendirilmiştir.
Yöntem: Bir tersiyer referans merkezinin immünoloji polikliniğine 2017 ile 2024 yılları arasında başvuran 180 premenopozal kadın çalışmaya dahil edildi. Enfeksiyon öyküsüne ilişkin veriler, hastalara sık ve ciddi enfeksiyonlara yönelik hazırlanan altı sorudan oluşan bir sorgulama formu ile rutin görüşme sırasında toplanmış ve bu bilgiler reçeteler, radyolojik görüntüler veya ilgili hekim kayıtları üzerinden ulusal sağlık sisteminden doğrulanmıştır. Ölçülen parametreler arasında hemoglobin, ferritin, immünoglobulinler (IgG, A, M), IgG alt grupları, lenfosit alt grupları (CD3+, CD4+, CD8+, CD19+, CD16+56+) ve BBH’ler (CD19+CD27+IgM−IgD−) yer almıştır. Katılımcılar DEA, DE ve hemoglobin ile ferritin düzeyleri normal olan kontrol grubu olmak üzere üç gruba ayrılmıştır.
Bulgular: DEA grubunda toplam lenfosit sayısı, doğal öldürücü hücre (NK) sayısı, B lenfositler içindeki BBH yüzdesi ve IgG düzeyi kontrol grubuna göre anlamlı düzeyde daha düşüktü. BBH ve IgG1 düzeyleri açısından DEA grubu her iki gruptan da daha düşük değerler göstermiştir. DEA grubunda tekrarlayan pnömoni öyküsü diğer gruplara göre daha yaygındı.
Sonuç: DEA’lı premenopozal kadınlarda lenfosit, NK hücreleri, IgG, IgG1 ve BBH düzeylerindeki azalma ile birlikte tekrarlayan pnömoni sıklığındaki artış, patojenlere karşı bağışıklık yanıt kapasitesinde bir azalmaya işaret ediyor olabilir. Bellek B hücrelerinin enfeksiyonlara veya aşılara karşı uzun süreli, hatta ömür boyu sürebilen immün yanıtların oluşumundaki rolü göz önünde bulundurulduğunda, DEA ile BBH düzeyleri arasındaki olası ilişki, uzun vadeli bağışıklığın sürdürülebilirliği açısından araştırmaya açık ve önemli bir alan olarak değerlendirilebilir.

Anahtar Kelimeler

Demir Eksikliği Anemisi , Premenopoz , Humoral İmmünite , Bellek B Hücresi , Lenfosit Subgrupları , İmmunglobulin

Kaynakça

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