Exploring the Role of Visfatin and Interleukin-10 in the Immune Regulation of Aplastic Anemia: Correlation with Bone Marrow Hypocellularity

BACKGROUND: Aplastic anemia (AA) is a life-threatening bone marrow failure condition marked by pancytopenia in the peripheral blood and bone marrow hypocellularity. AIMS OF THE STUDY: Investigate the roles of visfatin and interleukin-10 (IL-10) in the immune regulation of AA and to examine their correlation with bone marrow hypocellularity. METHODOLOGY: A case–control study was conducted from January to June 2025 at Nasiriyah General Hospital, Iraq, with IRB approval and informed consent. It included 150 AA patients and 50 matched healthy controls (ages 25–45). Diagnosis was confirmed by clinical evaluation, bone marrow biopsy, and complete blood count (CBC). Participants with infections, autoimmune diseases, malignancies, or immunosuppressive therapy were excluded. Blood samples were analyzed for CBC and serum levels of visfatin and IL-10 using ELISA. All assays were performed in duplicate for accuracy. RESULTS: The study found that there were no statistically significant differences between the AA patients and the controls in terms of age, gender, BMI, or smoking. It was still much higher in the patients for visfatin (37.5 ± 8.6 ng/ml vs. 22.1 ± 6.3 ng/ml) and IL-10 (14.8 ± 3.5 pg/ml vs. 9.2 ± 2.7 pg/ml) ( P < 0.001). The levels of white blood cell, red blood cell, hemoglobin, and platelets in the patients’ blood were significantly lower ( P < 0.001). Serum levels of visfatin and IL-10 were negatively correlated with bone marrow hypocellularity, with correlation coefficients of r = −0.52 and r = −0.45, respectively. CONCLUSIONS: Visfatin and IL-10 were elevated in AA patients and inversely correlated with bone marrow hypocellularity, suggesting a potential immunoregulatory role in supporting hematopoietic recovery.