The profile of the t helper, cytotoxic t and natural killer cells in sickle cell anemia patients with ischemic attack and the relation with clinical prognosis

ABSTRACT The Profile of the T Helper, Cytotoxic T and Natural Killer Cells in Sickle Cell Anemia Patients with Ischemic Attack and the Relation with Clinical Prognosis Purpose: The study is conducted in Pediatric Hematology of Medical Faculty of the University of Çukurova in 29 sickle cell anemia (SCA) patients, who are in ischemic attacks (in vasoocclusive crises period) and in steady state; the estimation of relation with clinical prognosis and the effect of ischemic attacks on immunological functions by comparisons of the level of T helper cells, cytotoxic T cells and natural killer cells. Materials and Methods: In the study, 29 patients with sickle cell anemia in ischemic attacks with painful crises and in steady state and 24 healthy children were chosen in the same age group for control group. These groups were examined with complete blood cells count, the hemoglobin electrophoreses and the blood chemistry. The study was performed by flowcytometric method to find the level of CD3 monoclonal antibody for total T lymphocyte, CD4 monoclonal antibody for T helper cells, CD8 monoclonal antibody for cytotoxic T cells and CD16+56 monoclonal antibodies for natural killer cells in the mentioned groups to compare the statistical data. Findings: The average of HbS ischemic periods in SCA patients are to be found 83±6,6 %. There were decrease in hemoglobin and hematocrit levels in SCA versus control group (p<0,001). The levels of CD3 are lower in SCA patients with crises period (62,31±7,79 %) than in steady state (65,53±5,72 %) and in control group (69,09±9,18 %) (p=0,007). The natural killer cells in crisis period (13,07±7,67 %) and in steady state (12,71±5,62 %) were lower than in control group (8,11±4,67 %) (p=0,009). In SCA patients, the level of CD3,CD4, CD8 and CD16+56(+) T cells are not changed with the frequency of crisis (p>0,05). Results: As a result of the study, in the patients with sickle cell anemia whom associated with chronic hemolysis and tissue hypoxia during the ischemic attack, the levels of total T lymphocyte (CD3) was found significantly lower than the control group. The levels of T helper cells (CD4) and cytotoxic T cells (CD8) did not differ between SCA patients and control group. The levels of natural killer cells (CD16+56) was found higher in crises period and steady state than control group. To find the T cell subset levels in clinical and prognostic effects in SCA, it is necessary to do study with bigger groups of patients and wide range of study. Key words: sickle cell anemia, T cell profile, vasoocclusive crises