Zinc supplementation and cellular immune response in splenectomized thalassemia major.

Background Thalassemia patients are generally immunocompromised, making them susceptible to infection. A study at the Thalassemia Center at Dr. Cipto Mangunkusumo Hospital, Jakarta, showed that all thalassemia patients experienced zinc deficiency. Decreased cellular immune response has been associated with zinc deficiency, and splenectomy exacerbates the risk of infection. Objective To evaluate for improvement of cellular immune response in splenectomized thalassemia major patients after zinc supplementation. Methods This randomized, double-blind, controlled trial was conducted on splenectomized thalassemia major patients over a 12-week period. The inclusion criteria were splenectomized thalassemia major patients aged > 12 to 18 years with negative HIV test results. Patients receiving corticosteroids were excluded. Fifty-six subjects were randomly divided into two groups, the zinc group and the placebo group. Before and after the 12 -week treatment, we evaluated subjects' serum zinc, T lymphocyte count, CD4+ T lymphocyte count, CD8+ T lymphocyte count, and CD4+/CD8+ ratio and were analyzed with unpaired T-test, Mann Whitney test, and Wilcoxon Signed Rank test. Results After zinc supplementation, serum zinc serum levels in 18/28 subjects in the zinc group became normalized. None of the cellular immune response parameters were significantly different between the two groups after zinc supplementation (P > 0.05). This finding might have been due to the subjects' compliance which was lower in the zinc group (75.82%) than in the placebo group (83.19%). Conclusion Cellular immune response in splenectomized thalassemia major patients is not significantly changed after 12 weeks of zinc supplementation. [ABSTRACT FROM AUTHOR]