Evaluation of soluble transferrin receptor and malondialdehyde levels associated with ferroptosis in children with familial Mediterranean fever in remission

OBJECTIVE: Familial Mediterranean fever, an autoinflammatory disease, is characterized by recurrent stereotypic febrile attacks associated with an inflammatory syndrome. Malondialdehyde, a lipid peroxidation marker, and soluble transferrin receptor, a key regulator of cellular iron homeostasis, are important markers associated with ferroptosis. The aim of this study was to investigate the levels of these markers in children with familial Mediterranean fever in remission. METHODS: The study included 30 pediatric familial Mediterranean fever patients in remission who were being monitored in the hospital and 30 healthy children. Malondialdehyde and soluble transferrin receptor levels were analyzed using enzyme-linked immunosorbent assay. Malondialdehyde and soluble transferrin receptor levels were compared between groups. Correlation analyses were also performed separately for each group to assess the relationship between these two parameters. RESULTS: Serum amyloid A, erythrocyte sedimentation rate, and creatinine levels were higher and hematocrit levels were lower in the familial Mediterranean fever group compared to the control. No significant difference was found in malondialdehyde and soluble transferrin receptor levels between the two groups. There was a positive correlation between malondialdehyde and soluble transferrin receptor levels in both groups (familial Mediterranean fever r=0.803, control r=0.599). CONCLUSION: Although there was no significant difference in mean malondialdehyde and soluble transferrin receptor levels between children with familial Mediterranean fever in remission and a healthy control group, the high correlation coefficient between these two parameters in familial Mediterranean fever patients suggests a possible link between iron imbalance and oxidative stress in the pathophysiology of the disease. These findings highlight the need for larger, multicenter studies, including patients in the exacerbation phase, to better elucidate the role of ferroptosis in familial Mediterranean fever.