Role of adiponectin in chronic lymphocytic leukemia

Background: Assessing for clinical stage and searching for various new prognostic markers can be useful in better understanding chronic lymphocytic leukemia (CLL) pathogenesis and in deciding when to initiate therapy and how this therapy can be effective. Adiponectin is an abundant circulating adipokine that exhibits beneficial effects in the vasculature and has anti-inflammatory, antiproliferative, and proapoptotic properties.Aim of the study: The aim of this study was to investigate the role of adiponectin in CLL pathogenesis and its relation to the well-established CLL prognostic factors.Participants and methods: Forty-five individuals divided into two groups were included. Group I comprised 35 patients classified into three subgroups (Ia: the low-risk group; Ib: the intermediate-risk group; and Ic: the high-risk group). Group II comprised 10 apparently healthy age and sex-matched controls. In addition to routine laboratory investigations, β2-microglobulin (β2-MG) and adiponectin and angiogenin (ANG) were measured by immunoturbidimetry and ELISA techniques, respectively. ZAP-70 and CD38 expressions were assessed by flow cytometry.Results: Adiponectin was significantly lower in patients than in controls. It was significantly lower in subgroup Ic than in subgroup Ia (P 0.01), whereas the P-value was nonsignificant when Ib was compared with Ia and Ic. ANG was significantly higher in patients than in controls (P 0.001) and its level increased with clinical stage (Ia Ib Ic) with P-value less than 0.0001. Regarding β2-MG, it was higher in patients than in controls and the Ic subgroup had a significantly higher level compared with Ia and Ib subgroups (P 0.001) with no significant difference between these two subgroups. ZAP-70 expression was positive in 45.7% of the patients who had significantly lower adiponectin levels than those who were ZAP-70 expression negative (P 0.01). Forty percent of the patients were positive for CD38 expression with significantly lower adiponectin levels compared with CD38-negative patients (P 0.01). Adiponectin was inversely correlated to ANG, β2-MG, and percentages of ZAP-70-expressing and CD38-expressing cells.Conclusion: These results support a key role for adiponectin in CLL, suggesting a possible promising therapeutic potential.