Cholinesterases as hemolytic and Inflammatory markers in Beta thalassemia trait patients

Beta thalassemia trait (BTT) is one of the most common monogenic disorders characterized by increased alpha and gamma chains with concomitant decrease in beta chains. These patients are clinically asymptomatic with mild anemia, subclinical inflammation and endothelial dysfunction. This study was undertaken to determine the role of cholinesterases in BTT. The study population included 30 BTT patients and 30 age and sex matched controls. Patients were labelled as BTT only if they had Hb A2 >3.5 and/ HbF>2 by variant analysis using cation HPLC. Percentage hemolysis, erythrocyte acetyl cholinesterase (AChE), plasma butyryl cholinesterase (BChE) and globulins were estimated by spectrophotometric methods. Intracellular adhesion molecule (ICAM-1) was evaluated by ELISA. Percentage hemolysis was significantly high in BTT patients. Both the cholinesterases were lower in BTT patients compared to controls. Decrease in BChE was statistically significant (p< 0.0001). An apparent increase in plasma ICAM-1 was observed in BTT patients compared to the normal group. The increase in plasma globulins was statistically significant in BTT (p<0.0001). AChE and HbA1C showed significant negative correlation with percentage hemolysis. Further, acetylcholinesterases showed a statistically significant negative correlation with ICAM-1. A negative correlation between globulins and cholinesterases in BTT, highlights the involvement of cholinesterases in inflammation.Based on our findings, we conclude that cholinesterases play a key role in inflammation and can be considered as biomarkers of hemolysis in BTT.