{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:47:12Z","timestamp":1791978432079,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Iron deficiency can impair immune function, increasing tuberculosis (TB) susceptibility and severity. The research aimed to investigate iron deficiency anemia in TB patients and household contacts and its association with natural resistance\u2010associated macrophage protein 1 (NRAMP1) polymorphism and expression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The levels of iron, ferritin, and transferrin were measured in the serum by ELISA (Enzyme\u2010Linked Immunosorbent Assay). <jats:italic>NRAMP1<\/jats:italic> polymorphisms were determined by polymerase chain reaction (PCR) and sequencing. <jats:italic>NRAMP1<\/jats:italic> gene expression was measured by real\u2010time PCR. Interferon\u2010gamma release assay (IGRA) checked on household contacts to screen household contacts with positive IGRA as the control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study involved 35 TB cases and 35 TB contacts. The results showed that the serum Fe levels were found to be lower in the TB case group (median 149.6\u2009\u03bcmol\/L) than in the positive IGRA household contacts group (median 628.53\u2009\u03bcmol\/L) with a <jats:italic>p<\/jats:italic>\u2010value &lt;0.001. Meanwhile, ferritin levels in TB cases tended to be higher, in contrast to transferrin, which was found to tend to be lower in TB cases than household contacts but did not show a significant difference. This study found no association between the polymorphism of exon 15 D543 and active TB. However, <jats:italic>NRAMP1<\/jats:italic> gene expression was lower in TB cases than in positive IGRA household contacts (<jats:italic>p<\/jats:italic>\u00a0=\u20090.011). Besides, there was a positive correlation between <jats:italic>NRAMP1<\/jats:italic> gene expression and serum Fe levels (r\u2009=\u20090.367, <jats:italic>p<\/jats:italic>\u00a0=\u20090.006). TB was associated with decreased <jats:italic>NRAMP1<\/jats:italic> gene expression (OR 0.086 95% CI 0.02\u20130.366, <jats:italic>p<\/jats:italic>\u00a0=\u20090.001). Besides, TB was associated with low Fe levels (OR 0.533 95% CI 0.453\u20130.629, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Comparing the TB case to the household contacts group, decreased serum Fe levels were discovered in the TB case group. This study also shows a correlation of <jats:italic>NRAMP1<\/jats:italic> gene expression to Fe levels in TB patients and household contacts and describes that TB may lead to decreased Fe levels by downregulating <jats:italic>NRAMP1<\/jats:italic> expression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13677","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T22:29:48Z","timestamp":1692743388000},"page":"893-904","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Serum iron levels in tuberculosis patients and household contacts and its association with natural resistance\u2010associated macrophage protein 1 polymorphism and expression"],"prefix":"10.1111","volume":"17","author":[{"given":"Wiendra","family":"Waworuntu","sequence":"first","affiliation":[{"name":"Pusat Kebijakan Sumber Daya dan Sistem Ketahanan Kesehatan, Badan Kebijakan Pembangunan Kesehatan Ministry of Health Republic 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