Original Article

Comparative Clinical Pathology

, Volume 23, Issue 3, pp 725-733

First online:

Role of serum pro-hepcidin and GSTM1 and GSTT1 null polymorphisms for estimation of the risk of myocardial siderosis in children and “young adults” with β-thalassemia major

  • Ivan ChakarovAffiliated withDepartment of Pediatrics, Medical Faculty, Trakia University
  • , Tatyana VlaykovaAffiliated withDepartment of Chemistry and Biochemistry, Medical Faculty, Trakia University Email author 
  • , Emil SlavovAffiliated withDepartment of Molecular Biology, Immunology and Medical Genetics, Medical Faculty, Trakia University
  • , Rumen MarinovAffiliated withClinic of Pediatrics, National Center of Heart Diseases
  • , Petrana ChakarovaAffiliated withDepartment of Pediatrics, Medical Faculty, Trakia University

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Abstract

This study aims to evaluate the serum pro-hepcidin level in β-thalassemia patients, to clarify its relation with serum level of ferritin and to assess the possible role of null polymorphisms of glutathione S-transferase genes, GSTM1 and GSTT1, for susceptibility to β-thalassemia and myocardial siderosis. The serum level of pro-hepcidin was assessed in 31 patients [16 children (52 %) and 15 young adults (48 %)] with β-thalassemia and nine healthy individuals [four children (44 %) and five young adults (56 %)] applying ELISA method. Genotyping for the null polymorphisms of GSTM1 and GSTT1 was performed successfully by multiplex PCR in 17 patients and in 40 healthy individuals, which were enrolled in the case–control study for assessment of the role of these polymorphisms as risk factors for β-thalassemia. The mean serum level of pro-hepcidin in patients did not differ significantly (159.12 ± 70.12 ng/ml) from that in controls (144.64 ± 53.30 ng/ml). We found a significant positive correlation with the serum ferritin (R = 0.371, p = 0.039). In addition, there was an association between the serum pro-hepcidin and the type of chelating therapy. The frequency of GSTT1 null genotypes was significantly higher in patients than in controls (0.29 vs. 0.07, p = 0.025). We observed tendencies for a higher serum ferritin and lower value of ejection fraction of the left ventricle (EFLV) of the patients carrying GSTT1 null genotypes than those with non-null GSTT1 genotypes. The serum levels of pro-hepcidin is not the most precise markers of iron overload and organ dysfunction, but it could be considered as a relatively good alternative of the serum ferritin as an index of iron stores. In addition, we suggest that GSTT1 null genotype could be considered as a predisposing factor for β-thalassemia, myocardial siderosis, and dysfunction in patients with this disease.

Keywords

β-thalassemia GSTT1 GSTM1 Gene polymorphisms Hepcidin Iron overload