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Abstract Ionizing radiation has a serious impact on various biological systems, especially the immune system. The immune system response to ionizing radiation can be assessed by estimating changes in the number of cells. There is a relationship between the influence of the immune system, the radiation dose and the genetic genes of each individual. Ionizing radiation produces immunosuppression mainly through the destruction of cells. The immune cells are very radiosensitive and their reduction is currently used as an early indicator of the level of an accidental acute exposure. Persisting effects on the immune system have been observed after exposure to ionizing radiation. There must be a strong justification for the excessive use of radiological examinations in children and young adults to prevent side effects of radiation on the immune system. Meta-analysis is a statistical method for combining studies with different statistical results related to a particular subject and showing a lot of data, which gives them greater statistical results. Online research was done for studies focused on ionizing radiation effects on immune system which published national and international, between 2001, to the end of 2018. 200 studies were examined then checked and overlapping citations were removed from them. The pool of 36 studies were found, which focused on effects of ionizing radiation on immune system.11 studies were pooled in Arabic countries with study group’s sample size (485) those exposed to ionizing radiation and control group’s sample size (393) those healthy and never exposed to ionizing radiation. And 25 studies were pooled in non-Arabic countries with study group’s sample size (3478) those exposed to ionizing radiation and control group’s sample size (900) those healthy and never exposed to ionizing radiation. Meta-analysis study was conducted for the eligible studies by using MedCalc software ver. 12.7.7.0. Meta-analysis was carried out for the following variables which were possible, evaluated and available in the pooled studies : WBC, lymphocyte, Neutrophils, Monocytes, CD3 %, CD4 %, CD8 %, CD16 %, CD19 %, IL-2, IL-4, IL-10, IFN-γ, IgM, IgA, IgG and C3. Regarding the Meta-analysis study of the variables which were possible, evaluated and available in the studies pooled in the Arab countries. The study showed that the mean values of WBC, lymphocyte, neutrophil, monocyte count (103cell/μL) and CD4% in study groups were (7.28±0.77, 2.40±0.46, 4.03±0.57, 1.17±1.33 (103cell/μL) and 44.15± 4.88 %) respectively. While, the mean values of WBC, lymphocyte, neutrophil, monocyte count (103cell/μL) and CD4% in control groups were (7.36±1.19, 2.54±0.60, 4.30±1.04, 1.43±1.47 (103cell/μL) and 47.75±3.32 %) respectively. This means that the studied groups were more affected by the decrease in their variables than the controlled after exposure to ionizing radiation with highly statistically significant differences (P ≤ 0.001). As regard the Meta-analysis study of the variables which were possible, evaluated and available in the studies pooled in the non-Arab countries. The study showed that the mean values of WBC, lymphocyte, neutrophils, monocytes (103cell/μL), CD3 %, CD4 %, CD8 %, CD16 %, CD19 %, IL-2, IL-10 (pg/ml), IgM, IgG and C3 (g/L) in studied groups were (6.99±0.64, 2.24±0.38, 3.77±0.49, 0.30±0.20 (103cell/μL), 63.00±8.63%, 38.50±10.66%, 27.52±5.37%, 15.675±0.9287%, 11.74±2.68%, 137.00±226.96, 287.65±379.50 (pg/ml), 1.30±0.32, 11.08±1.68 and 1.10±0.14 (g/L)) respectively. While, the mean values of WBC, lymphocyte, neutrophils, monocytes (103cell/μL), CD3 %, CD4 %, CD8 %, CD16 %, CD19 %, IL-2, IL-10 (pg/ml), IgM, IgG and C3 (g/L) in controlled groups were (7.54±2.33, 2.36±0.32, 3.950±0.4041, 0.37±0.2 (103cell/μL), 67.27±6.39 %, 41.79±8.82%, 28.96±3.71%, 18.67±3.19%, 12.78±3.48%, 257.16±435.51, 858.37±1178.92 (pg/ml), 1.50±0.46, 12.17±1.64 and 1.35±0.21 (g/L)) respectively. Meaning the studied groups were more affected by the decrease in their variables than the controlled after exposure to ionizing radiation with highly statistically significant differences (P ≤ 0.001). Furthermore, regarding to the Meta-analysis study of the variables which were possible, evaluated, and available in the studies pooled in the non-Arab countries. The study showed that the mean values of IL-4, IFN-γ (pg/ml) and IgA (g/L) in the studied groups were (57.52±108.34, 70.40±98.01 and 2.50±0.65 (g/L)) respectively. While, the mean values of IL-4, IFN-γ (pg/ml) and IgA(g/L) in the controlled groups were (38.100±71.28, 50.34±59.37 (pg/ml) and 2.42±0.32 (g/L)) respectively. Briefly, the studied groups were more affected by the increase in their variables than the controlled after exposure to ionizing radiation with highly statistically significant differences (P < 0.001). Hence, it could be concluded that exposure to ionizing radiation has a significant impact on the immune cells. |