ABSTRACT
The interaction of metals with the immune system appears to constitute a unique class of modulatory effects affecting reactions at levels. In addition to being essential for the activity of key enzymes and hormones, some metals may exert effects at the cell surface and affect signaling either at the level of receptors or cytokines in processes which can involve gene activation, as discussed in several chapters in this volume. The effect of altered trace element metabolism on immune response, particularly in the chronically transfused patient, is currently under investigation in our laboratory as a possible cofactor in the iron-associated morbidity of the thalassemia patient. Cells acquire iron from tranferrin by a process of receptor-mediated endocytosis and in association with this produce upregulation of transferrin receptors during growth. Reduced zinc has been suggested as a potential basis for the growth retardation seen in thalassemia patients in whom treatment was started before the age of 3.
