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Sadek SA, Marzouk M, Mohamed HRH, El-Sallam BFA, Elfiky AA, Sayed AA. Chia seeds and coenzyme Q 10 alleviate iron overload induced hepatorenal toxicity in mice via iron chelation and oxidative stress modulation. Sci Rep 2023; 13:19773. [PMID: 37957293 PMCID: PMC10643458 DOI: 10.1038/s41598-023-47127-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023] Open
Abstract
Iron overload (IOL) can cause hepatorenal damage due to iron-mediated oxidative and mitochondrial damage. Remarkably, combining a natural iron chelator with an antioxidant can exert greater efficacy than monotherapy. Thus, the present study aimed to evaluate the efficacy of Chia and CoQ10 to chelate excess iron and prevent hepatorenal oxidative damage in IOL mice. Male Swiss albino mice (n = 49) were randomly assigned to seven groups: control, dietary Chia, CoQ10, IOL, IOL + Chia, IOL + CoQ10, and IOL + Chia + CoQ10. Computational chemistry indicates that the phytic acid found in the Chia seeds is stable, reactive, and able to bind to up to three iron ions (both Fe2+ and Fe3+). IOL induced a significant (P < 0.05) increase in serum iron, ferritin, transferrin, TIBC, TSI, RBCs, Hb, MCV, MCH, WBCs, AST, ALT, creatinine, and MDA. IOL causes a significant (P < 0.05) decrease in UIBC, platelets, and antioxidant molecules (GSH, SOD, CAT, and GR). Also, IOL elicits mitochondrial membrane change depolarization, and DNA fragmentation and suppresses mitochondrial DNA copies. Furthermore, substantial changes in hepatic and renal tissue, including hepatocellular necrosis and apoptosis, glomerular degeneration, glomerular basement membrane thickening, and tubular degeneration, were observed in the IOL group. Dietary Chia and CoQ10 induced significant (P < 0.05) amelioration in all the mentioned parameters. They can mostly repair the abnormal architecture of hepatic and renal tissues induced by IOL, as signified by normal sinusoids, normal central veins, and neither glomerular damage nor degenerated tubules. In conclusion, the combined treatment with Chia + CoQ10 exerts more pronounced efficacy than monotherapy in hepatorenal protection via chelating excess iron and improved cellular antioxidant status and hepatorenal mitochondrial function in IOL mice.
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Affiliation(s)
- Shimaa A Sadek
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Mohamed Marzouk
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Hanan R H Mohamed
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt.
| | | | - Abdo A Elfiky
- Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Amany A Sayed
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
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Tomosugi N, Koshino Y, Ogawa C, Maeda K, Shimada N, Tomita K, Daimon S, Shikano T, Ryu K, Takatani T, Sakamoto K, Ueyama S, Nagasaku D, Nakamura M, Ra S, Nishimura M, Takagi C, Ishii Y, Kudo N, Takechi S, Ishizu T, Yanagawa T, Fukuda M, Nitta Y, Yamaoka T, Saito T, Imayoshi S, Omata M, Oshima J, Onozaki A, Ichihashi H, Matsushima Y, Takae H, Nakazawa R, Ikeda K, Tsuboi M, Konishi K, Kato S, Ooura M, Koyama M, Naganuma T, Ogi M, Katayama S, Okumura T, Kameda S, Shirai S. Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial. Int J Mol Sci 2023; 24:13779. [PMID: 37762085 PMCID: PMC10531220 DOI: 10.3390/ijms241813779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/27/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (ΔFe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to ΔFe2h, and the secondary outcome was the description of the predictors of the body's iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. ΔFe2h increased when hepcidin-25 and TSAT decreased (-0.459, -0.643 to -0.276, p = 0.000; -0.648, -1.099 to -0.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (-1.392, -1.749 to -1.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake.
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Affiliation(s)
- Naohisa Tomosugi
- Division of Systems Bioscience for Drug Discovery, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku 920-0293, Ishikawa, Japan
| | | | - Chie Ogawa
- Maeda Institute of Renal Research Musashikosugi, Kawasaki 211-0063, Kanagawa, Japan;
| | - Kunimi Maeda
- Maeda Institute of Renal Research Shakujii, Nerima 177-0041, Tokyo, Japan;
| | | | - Kimio Tomita
- The Chronic Kidney Disease Research Center, Tomei Atsugi General Hospital, Atsugi 243-8571, Kanagawa, Japan;
| | - Shoichiro Daimon
- Department of Nephrology, Daimon Clinic for Internal Medicine, Nonoichi 921-8802, Ishikawa, Japan;
| | - Tsutomu Shikano
- Kyoto Okamoto Memorial Hospital, Kuze 613-0034, Kyoto, Japan; (T.S.); (K.R.)
| | - Kazuyuki Ryu
- Kyoto Okamoto Memorial Hospital, Kuze 613-0034, Kyoto, Japan; (T.S.); (K.R.)
| | - Toru Takatani
- Nephrology Division, Tojinkai Hospital, Fushimi 612-8026, Kyoto, Japan;
| | - Kazuya Sakamoto
- Department of Urology, Tomakomai Nisshou Hospital, Tomakomai 053-0803, Hokkaido, Japan;
| | - Satonori Ueyama
- Jinaikai Ueyama Hospital, Kagoshima 890-0073, Kagoshima, Japan;
| | | | | | - Shibun Ra
- Noheji Clinic, Noheji 039-3152, Aomori, Japan;
| | | | | | - Yoji Ishii
- Nozatomon Clinic, Himeji 670-0011, Hyogo, Japan;
| | | | | | - Takashi Ishizu
- Department of Nephrology, Tsukuba Central Hospital, Ushiku 300-1211, Ibaraki, Japan; (T.I.); (T.Y.)
| | - Takamoto Yanagawa
- Department of Nephrology, Tsukuba Central Hospital, Ushiku 300-1211, Ibaraki, Japan; (T.I.); (T.Y.)
| | | | - Yutaka Nitta
- The Department of Nephrology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan; (Y.N.); (T.Y.)
| | - Takayuki Yamaoka
- The Department of Nephrology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan; (Y.N.); (T.Y.)
| | - Taku Saito
- Saito Memorial Hospital, Kawaguchi 332-0034, Saitama, Japan; (T.S.); (S.I.)
| | - Suzuko Imayoshi
- Saito Memorial Hospital, Kawaguchi 332-0034, Saitama, Japan; (T.S.); (S.I.)
| | - Momoyo Omata
- Department of Internal Medicine, Hachioji Azumacho Clinic, Hachioji-shi 192-0082, Tokyo, Japan;
| | - Joji Oshima
- Kubojima Clinic, Kumagaya 360-0831, Saitama, Japan;
| | - Akira Onozaki
- Tokatsu-Clinic Hospital, Matsudo 271-0067, Chiba, Japan;
| | | | | | | | | | - Koichi Ikeda
- Tokatsu Clinic Koiwa, Edogawa 133-0056, Tokyo, Japan;
| | - Masato Tsuboi
- Kaikoukai Anjo Kyoritsu Clinic, Anjo 446-0065, Aichi, Japan;
| | | | - Shouzaburo Kato
- Nishi Interchange Clinic for Internal Medicine and Dialysis, Kanazawa 921-8001, Ishikawa, Japan;
| | - Maki Ooura
- Maro Clinic, Tanabe 646-0004, Wakayama, Japan;
| | | | - Tsukasa Naganuma
- Department of Nephrology, Yamanashi Prefectural Central Hospital, Kofu 400-0027, Yamanashi, Japan;
| | - Makoto Ogi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, Gotemba 412-0043, Shizuoka, Japan;
| | | | | | - Shigemi Kameda
- Joetsu General Hospital, Joetsu 943-8507, Niigata, Japan;
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, Yokohama 241-0811, Kanagawa, Japan;
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3
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Individualized anemia management enhanced by ferric pyrophosphate citrate protocol. Sci Rep 2022; 12:20122. [PMID: 36418453 PMCID: PMC9684411 DOI: 10.1038/s41598-022-23262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 10/27/2022] [Indexed: 11/24/2022] Open
Abstract
The optimal use of erythropoiesis-stimulating agents (ESAs) and parenteral iron in managing anemia in end-stage renal disease (ESRD) remains controversial. One-size-fits-all rule-based algorithms dominate dosing protocols for ESA and parenteral iron. However, the Food & Drug Administration (FDA) guidelines for using ESAs in chronic kidney disease recommend individualized therapy for the patient. This prospective quality assurance project was at a single hemodialysis (HD) center comprising three 6-month phases (A, B, C) separated by 3-month washout periods. Standard bi-weekly ESA dose titration and intravenous (IV) iron sucrose protocols were used in baseline Phase A, and ferric pyrophosphate citrate (FPC) augmented iron in Phase B. In Phase C, an FPC protocol and weekly, individualized ESA management were used. We examined clinic-level mean differences in hemoglobin (Hb) and ESRD-related outcomes by phase with repeated ANOVA. To examine the Hb at the patient level, we used multi-level mixed-effect regression adjusting for phase, month, and other relevant confounders at each month over time to derive the mean marginal effects of phase. There were 54, 78, and 66 patients in phases A, B, and C, respectively, with raw mean Hb values of 9.9, 10.2, and 10.3 g/dL. The percentage of Hb values < 9 g/dL declined from 14.3% in Phase A to 7.6% in Phase C (p = 0.007). The multivariable mixed-effect regression results showed mean marginal Hb was higher by 0.3 mg/dL and 0.4 mg/dL in Phases B and C, respectively, compared to Phase A. We also observed reduced ferritin (p = 0.003) and transferrin saturation (TSAT) (p = 0.008) levels from Phase A to Phase C with the repeated ANOVA analysis. Ferric pyrophosphate citrate (FPC) appears to support more efficient ESA-stimulated erythropoiesis. Moreover, individualized ESA management combined with FPC (Phase C) was associated with further improvement in efficiency as we observed the fewest patients with Hb values < 9 g/dL concurrent with greater decreases in ferritin levels and reduced ESA doses. However, future prospective studies to confirm these findings on a larger, more diverse cohort of ESRD patients are warranted.
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Chronic High-Altitude Hypoxia Alters Iron and Nitric Oxide Homeostasis in Fetal and Maternal Sheep Blood and Aorta. Antioxidants (Basel) 2022; 11:antiox11091821. [PMID: 36139895 PMCID: PMC9495375 DOI: 10.3390/antiox11091821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
The mammalian fetus thrives at oxygen tensions much lower than those of adults. Gestation at high altitude superimposes hypoxic stresses on the fetus resulting in increased erythropoiesis. We hypothesized that chronic hypoxia at high altitude alters the homeostasis of iron and bioactive nitric oxide metabolites (NOx) in gestation. To test for this, electron paramagnetic resonance was used to provide unique measurements of iron, metalloproteins, and free radicals in the blood and aorta of fetal and maternal sheep from either high or low altitudes (3801 or 300 m). Using ozone-based chemiluminescence with selectivity for various NOx species, we determined the NOx levels in these samples immediately after collection. These experiments demonstrated a systemic redistribution of iron in high altitude fetuses as manifested by a decrease in both chelatable and total iron in the aorta and an increase in non-transferrin bound iron and total iron in plasma. Likewise, high altitude altered the redox status diversely in fetal blood and aorta. This study also found significant increases in blood and aortic tissue NOx in fetuses and mothers at high altitude. In addition, gradients in NOx concentrations observed between fetus and mother, umbilical artery and vein, and plasma and RBCs demonstrated complex dynamic homeostasis of NOx among these circulatory compartments, such as placental generation and efflux as well as fetal consumption of iron-nitrosyls in RBCs, probably HbNO. In conclusion, these results may suggest the utilization of iron from non-hematopoietic tissues iron for erythropoiesis in the fetus and increased NO bioavailability in response to chronic hypoxic stress at high altitude during gestation.
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5
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Association of erythropoietin and iron status with hematological parameters in iron deficiency anemia among primary school pupils. APPLIED NANOSCIENCE 2022. [DOI: 10.1007/s13204-021-02154-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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6
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Lo Presti V, Cornel AM, Plantinga M, Dünnebach E, Kuball J, Boelens JJ, Nierkens S, van Til NP. Efficient lentiviral transduction method to gene modify cord blood CD8 + T cells for cancer therapy applications. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2021; 21:357-368. [PMID: 33898633 PMCID: PMC8056177 DOI: 10.1016/j.omtm.2021.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/17/2021] [Indexed: 01/01/2023]
Abstract
Adoptive T cell therapy utilizing tumor-specific autologous T cells has shown promising results for cancer treatment. However, the limited numbers of autologous tumor-associated antigen (TAA)-specific T cells and the functional aberrancies, due to disease progression or treatment, remain factors that may significantly limit the success of the therapy. The use of allogeneic T cells, such as umbilical cord blood (CB) derived, overcomes these issues but requires gene modification to induce a robust and specific anti-tumor effect. CB T cells are readily available in CB banks and show low toxicity, high proliferation rates, and increased anti-leukemic effect upon transfer. However, the combination of anti-tumor gene modification and preservation of advantageous immunological traits of CB T cells represent major challenges for the harmonized production of T cell therapy products. In this manuscript, we optimized a protocol for expansion and lentiviral vector (LV) transduction of CB CD8+ T cells, achieving a transduction efficiency up to 83%. Timing of LV treatment, selection of culture media, and the use of different promoters were optimized in the transduction protocol. LentiBOOST was confirmed as a non-toxic transduction enhancer of CB CD8+ T cells, with minor effects on the proliferation capacity and cell viability of the T cells. Positively, the use of LentiBOOST does not affect the functionality of the cells, in the context of tumor cell recognition. Finally, CB CD8+ T cells were more amenable to LV transduction than peripheral blood (PB) CD8+ T cells and maintained a more naive phenotype. In conclusion, we show an efficient method to genetically modify CB CD8+ T cells using LV, which is especially useful for off-the-shelf adoptive cell therapy products for cancer treatment.
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Affiliation(s)
- Vania Lo Presti
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Annelisa M Cornel
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Maud Plantinga
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Ester Dünnebach
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Jurgen Kuball
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,Department of Hematology, UMC Utrecht, Utrecht, the Netherlands
| | - Jaap Jan Boelens
- Stem Cell Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stefan Nierkens
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Niek P van Til
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands.,AVROBIO, Inc., Cambridge, MA, USA.,Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit and Amsterdam Neuroscience, Amsterdam, the Netherlands
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7
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Dias GF, Grobe N, Rogg S, Jörg DJ, Pecoits-Filho R, Moreno-Amaral AN, Kotanko P. The Role of Eryptosis in the Pathogenesis of Renal Anemia: Insights From Basic Research and Mathematical Modeling. Front Cell Dev Biol 2020; 8:598148. [PMID: 33363152 PMCID: PMC7755649 DOI: 10.3389/fcell.2020.598148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/16/2020] [Indexed: 12/17/2022] Open
Abstract
Red blood cells (RBC) are the most abundant cells in the blood. Despite powerful defense systems against chemical and mechanical stressors, their life span is limited to about 120 days in healthy humans and further shortened in patients with kidney failure. Changes in the cell membrane potential and cation permeability trigger a cascade of events that lead to exposure of phosphatidylserine on the outer leaflet of the RBC membrane. The translocation of phosphatidylserine is an important step in a process that eventually results in eryptosis, the programmed death of an RBC. The regulation of eryptosis is complex and involves several cellular pathways, such as the regulation of non-selective cation channels. Increased cytosolic calcium concentration results in scramblase and floppase activation, exposing phosphatidylserine on the cell surface, leading to early clearance of RBCs from the circulation by phagocytic cells. While eryptosis is physiologically meaningful to recycle iron and other RBC constituents in healthy subjects, it is augmented under pathological conditions, such as kidney failure. In chronic kidney disease (CKD) patients, the number of eryptotic RBC is significantly increased, resulting in a shortened RBC life span that further compounds renal anemia. In CKD patients, uremic toxins, oxidative stress, hypoxemia, and inflammation contribute to the increased eryptosis rate. Eryptosis may have an impact on renal anemia, and depending on the degree of shortened RBC life span, the administration of erythropoiesis-stimulating agents is often insufficient to attain desired hemoglobin target levels. The goal of this review is to indicate the importance of eryptosis as a process closely related to life span reduction, aggravating renal anemia.
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Affiliation(s)
- Gabriela Ferreira Dias
- Graduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
- Renal Research Institute, New York, NY, United States
| | - Nadja Grobe
- Renal Research Institute, New York, NY, United States
| | - Sabrina Rogg
- Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - David J. Jörg
- Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - Roberto Pecoits-Filho
- Graduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | | | - Peter Kotanko
- Renal Research Institute, New York, NY, United States
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Mintz J, Mirza J, Young E, Bauckman K. Iron Therapeutics in Women's Health: Past, Present, and Future. Pharmaceuticals (Basel) 2020; 13:E449. [PMID: 33302392 PMCID: PMC7762600 DOI: 10.3390/ph13120449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/28/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023] Open
Abstract
Iron plays a unique physiological role in the maintenance of homeostasis and the pathological outcomes of the female reproductive tract. The dual nature of elemental iron has created an evolutionary need to tightly regulate its biological concentration. The female reproductive tract is particularly unique due to the constant cycle of endometrial growth and shedding, in addition to the potential need for iron transfer to a developing fetus. Here, iron regulation is explored in a number of physiologic states including the endometrial lining and placenta. While iron dysregulation is a common characteristic in many women's health pathologies there is currently a lack of targeted therapeutic options. Traditional iron therapies, including iron replacement and chelation, are common treatment options for gynecological diseases but pose long term negative health consequences; therefore, more targeted interventions directed towards iron regulation have been proposed. Recent findings show potential benefits in a therapeutic focus on ferritin-hepcidin regulation, modulation of reactive oxygen species (ROS), and iron mediated cell death (ferroptosis). These novel therapeutics are the direct result of previous research in iron's complex signaling pathway and show promise for improved therapy, diagnosis, and prognosis in women's health.
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Affiliation(s)
| | | | | | - Kyle Bauckman
- Department of Academic Affairs, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 33314, USA; (J.M.); (J.M.); (E.Y.)
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9
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Anturaniemi J, Zaldívar-López S, Moore R, Kosola M, Sankari S, Barrouin-Melo SM, Hielm-Björkman A. The effect of a raw vs dry diet on serum biochemical, hematologic, blood iron, B 12 , and folate levels in Staffordshire Bull Terriers. Vet Clin Pathol 2020; 49:258-269. [PMID: 32329096 PMCID: PMC7383997 DOI: 10.1111/vcp.12852] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 08/12/2019] [Accepted: 09/20/2019] [Indexed: 12/31/2022]
Abstract
Background To date, very few studies have compared the effects of different types of feeding practices on canine physiology, such as feeding exclusively dry, raw, or homemade foods. Objectives We aimed to report the changes in hematologic, serum biochemical, plasma folate, B12, and whole blood iron levels in dogs fed two different diets. Methods A pilot study was developed to compare the effects of a heat‐processed high carbohydrate (HPHC) and nonprocessed high‐fat (NPHF) diet. A total of 33 client‐owned Staffordshire Bull Terriers were used; 18 had canine atopic dermatitis, seven were healthy, and eight were grouped as “borderline” dogs since they did not fulfill at least six of Favrot's criteria. The comparisons were made between the diet groups at the end visit of the diet intervention, as well as within the diet groups during the study. Results Significant differences between and within the diet groups were observed, although the majority of outcomes remained within the RIs. The median time of diet intervention was 140 days. Red blood cell counts, mean cell hemoglobin concentrations, and platelet counts were significantly higher, and mean cell hemoglobin, mean cell volume, alkaline phosphatase, inorganic phosphorus, and cholesterol were significantly lower in the dogs fed the NPHF diet compared with those fed the HPHC diet after the diet trial was completed. In addition, folate, B12, and iron decreased significantly in the NPHF diet group. Conclusions This pilot study indicated that diet had an impact on blood values, although most remained within RIs, pointing out the need for further studies.
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Affiliation(s)
- Johanna Anturaniemi
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Sara Zaldívar-López
- Faculty of Veterinary Medicine, Genomics and Animal Breeding Group, Department of Genetics, University of Córdoba, Cordova, Spain
| | - Robin Moore
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Mikko Kosola
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Satu Sankari
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Stella M Barrouin-Melo
- School of Veterinary Medicine and Zootechny, Department of Anatomy, Pathology and Clinics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Anna Hielm-Björkman
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
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10
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Akizawa T, Macdougall IC, Berns JS, Yamamoto H, Taguchi M, Iekushi K, Bernhardt T. Iron Regulation by Molidustat, a Daily Oral Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitor, in Patients with Chronic Kidney Disease. Nephron Clin Pract 2019; 143:243-254. [PMID: 31387097 PMCID: PMC6979436 DOI: 10.1159/000502012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND/AIMS The current treatment for anemia associated with chronic kidney disease (CKD) includes the administration of erythropoiesis stimulating agents (ESAs) combined with iron supplementation. Molidustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, has potential to treat anemia associated with CKD through increased erythropoietin production and improved iron availability. Here, we report the effect of molidustat on iron metabolism. METHOD Parameters of iron metabolism were monitored in three 16-week, randomized, controlled, phase 2 studies assessing the safety and efficacy of molidustat in the treatment of anemia associated with CKD in different populations: treatment-naïve and previously ESA-treated patients not on dialysis, and previously ESA-treated patients on hemodialysis. Iron supplementation was left at the discretion of the investigator. RESULTS In treatment-naïve patients not on dialysis, transferrin saturation (TSAT), hepcidin, ferritin, and iron concentrations decreased with molidustat, whereas total iron binding capacity (TIBC) increased. Similar results were observed in previously ESA-treated patients not on dialysis, although changes in those parameters were larger in treatment-naïve than in previously ESA-treated patients. In previously ESA-treated patients receiving hemodialysis, hepcidin concentration and TIBC remained stable with molidustat, whereas TSAT and ferritin and iron concentrations increased. Generally, similar trends were observed in secondary analyses of subgroups of patients not receiving iron supplementation. CONCLUSIONS Molidustat is a potential alternative to standard treatment of anemia associated with CKD, with a different mechanism of action. In patients not receiving dialysis, molidustat increases iron availability. In patients receiving hemodialysis, further investigation is required to understand fully the mechanisms underlying iron mobilization associated with molidustat.
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Affiliation(s)
- Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan,
| | - Iain C Macdougall
- Department of Renal Medicine, King's College Hospital, London, United Kingdom
| | - Jeffrey S Berns
- Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hiroyasu Yamamoto
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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Aslan D. Addition of oral iron to plasma transfusion in human congenital hypotransferrinemia: A 10-year observational follow-up with the effects on hematological parameters and growth. Pediatr Blood Cancer 2018; 65. [PMID: 28895280 DOI: 10.1002/pbc.26789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 11/10/2022]
Abstract
Congenital hypotransferrinemia (OMIM 209300) is an extremely rare disorder of inherited iron metabolism. Since its description in 1961, only 16 cases have been reported. The defective gene and molecular defect causing this disorder and clinicolaboratory findings seen in the homozygous and heterozygous states have been documented in both humans and mice. However, due to the lack of follow-up studies of the described cases, the long-term prognosis remains unknown. We present a 10-year observational follow-up of a patient previously diagnosed on a molecular basis who was treated with a unique therapy of plasma transfusion fortified with oral iron, with satisfactory clinicolaboratory responses.
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Affiliation(s)
- Deniz Aslan
- Section of Hematology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
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12
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Stripeli F, Kapetanakis J, Gourgiotis D, Drakatos A, Tsolia M, Kossiva L. Post-transfusion changes in serum hepcidin and iron parameters in preterm infants. Pediatr Int 2018; 60:148-152. [PMID: 29236334 DOI: 10.1111/ped.13478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/16/2017] [Accepted: 08/22/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Packed red blood cell transfusion is common in preterm neonates. Hepcidin acts as a negative feedback iron regulator. Iron parameters such as immature reticulocyte fraction (IRF) and high-light-scatter reticulocytes (HLR) are used to clarify iron metabolism. Very little is known about the regulation of hepcidin in preterm infants because most reports have evaluated prohepcidin. The aim of this study was therefore to evaluate serum hepcidin and establish hematological parameters in preterm infants after transfusion. METHODS The subjects consisted of 19 newborns (10 boys) with mean gestational age 29.1 ± 2.0 weeks, who had been transfused at the chronological age of 44.84 ± 19.61 days. Blood sample was collected before the transfusion and thereafter at 5 days and at 1 month. Serum hepcidin and other iron parameters were evaluated. RESULTS Mean serum hepcidin before and 5 days after transfusion was significantly different (5.5 ± 5.1 vs 10 ± 7.9 ng/mL respectively, P = 0.005). IRF and % HLR were also decreased significantly, 5 days after transfusion (0.4 ± 0.2 vs 0.2 ± 0.1, P = 0.009; 1.4 ± 1.5% vs 0.5 ± 0.4%, P = 0.012, respectively). Changes in hepcidin 5 days after transfusion were correlated significantly with changes in mean corpuscular hemoglobin (β, 0.13; SE, 0.05; P = 0.017), total iron binding capacity (β, 3.74; SE, 1.56; P = 0.016) and transferrin (β, 2.9, SE, 1.4; P = 0.039). CONCLUSIONS Serum hepcidin concentration, along with IRF and HLR, are potentially useful in estimating pre- and post-transfusion iron status. Larger studies are needed to evaluate the sensitivity and specificity of hepcidin compared with ordinary iron parameters in premature infants.
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Affiliation(s)
- Fotini Stripeli
- Neonatal Intensive Care Unit, P&A Kyriakou Children's Hospital, Athens, Greece
| | - John Kapetanakis
- Neonatal Intensive Care Unit, P&A Kyriakou Children's Hospital, Athens, Greece
| | - Dimitris Gourgiotis
- Research Laboratory of Clinical Biochemistry-Molecular Diagnostics, P&A Kyriakou Children's Hospital, Athens, Greece
| | - Antonis Drakatos
- Laboratory of Biochemistry, P&A Kyriakou Children's Hospital, Athens, Greece
| | - Maria Tsolia
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P&A Kyriakou Children's Hospital, Athens, Greece
| | - Lydia Kossiva
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P&A Kyriakou Children's Hospital, Athens, Greece
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Ferritin Heavy Subunit Silencing Blocks the Erythroid Commitment of K562 Cells via miR-150 up-Regulation and GATA-1 Repression. Int J Mol Sci 2017; 18:ijms18102167. [PMID: 29039805 PMCID: PMC5666848 DOI: 10.3390/ijms18102167] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 11/17/2022] Open
Abstract
Erythroid differentiation is a complex and multistep process during which an adequate supply of iron for hemoglobinization is required. The role of ferritin heavy subunit, in this process, has been mainly attributed to its capacity to maintain iron in a non-toxic form. We propose a new role for ferritin heavy subunit (FHC) in controlling the erythroid commitment of K562 erythro-myeloid cells. FHC knockdown induces a change in the balance of GATA transcription factors and significantly reduces the expression of a repertoire of erythroid-specific genes, including α- and γ-globins, as well as CD71 and CD235a surface markers, in the absence of differentiation stimuli. These molecular changes are also reflected at the morphological level. Moreover, the ability of FHC-silenced K562 cells to respond to the erythroid-specific inducer hemin is almost completely abolished. Interestingly, we found that this new role for FHC is largely mediated via regulation of miR-150, one of the main microRNA implicated in the cell-fate choice of common erythroid/megakaryocytic progenitors. These findings shed further insight into the biological properties of FHCand delineate a role in erythroid differentiation where this protein does not act as a mere iron metabolism-related factor but also as a critical regulator of the expression of genes of central relevance for erythropoiesis.
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14
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Eslami1 O, Shidfar1 F, Akbari-Fakhrabadi2 M. Vitamin D and Cardiorespiratory Fitness in the General Population: A Systematic Review. INT J VITAM NUTR RES 2017; 87:330-341. [DOI: 10.1024/0300-9831/a000490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Abstract. Background: Up to now, the association between vitamin D and cardiorespiratory fitness (CRF) is still inconsistent and there is a lack of a comprehensive review on this topic. Aim: To systematically review the literature including both observational studies and randomized controlled trials (RCTs) on the association between vitamin D and CRF in the general population. Methods: The literature was investigated by exploring databases of PubMed, EMBASE, Scopus and ISI Web of Science as well as a manual search up to April 2017 by using related MeSH terms and key words. All the English-language articles that were conducted in the general population without any restriction on age range of participants and date of publication were included in the study. Results: Among the 731 records which were found initially, a total of 20 articles including 18 cross-sectional studies and 2 RCTs fulfilled the inclusion criteria. Among the cross-sectional studies, findings on the association between serum 25(OH) D and CRF were incongruent. Additionally, studies which had reported significant results varied remarkably in terms of sample size, study population and the effect size of the association. In addition, RCTs found no significant improvement in CRF following vitamin D supplementation. Conclusion: Overall, evidence from cross-sectional studies does not support a strong association between vitamin D and CRF, although a number of studies demonstrated modest positive associations. Furthermore, limited RCTs did not confirm such an association. Further high quality research is needed to obtain a definite conclusion on this topic. “
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Affiliation(s)
- Omid Eslami1
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar1
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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15
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Abstract
BACKGROUND Severe traumatic injury is associated with bone marrow dysfunction that manifests as impaired erythropoiesis and prolonged hematopoietic progenitor cell (HPC) mobilization from the bone marrow. Extramedullary erythropoiesis, the development of red blood cells outside the bone marrow, has not been studied after severe injury and critical illness. This study examined the influence of lung contusion/hemorrhagic shock (LCHS) followed by chronic stress (CS) on the rodent spleen and to investigate the involvement of the splenic erythropoietin (EPO)/EPO receptor and BMP4 signaling. METHODS Male Sprague-Dawley rats were subjected to LCHS and LCHS/CS. Animals underwent 2 hours of daily restraint stress until the day of sacrifice. On day 7, the spleen was assessed for weight, growth of splenic colony-forming units (CFU)-granulocyte-, erythrocyte-, monocyte- megakaryocyte (GEMM), burst-forming unit-erythroid (BFU-E), and CFU-E colonies, the presence of HPCs, and splenic mRNA expression of bone morphogenetic protein 4 (BMP4), EPO and its receptor. Data were presented as mean ± SD; *p < 0.05 vs. naïve and **p < 0.05 vs. LCHS by t test. RESULTS On day 7, the addition of CS to LCHS increased spleen weight by 22%. LCHS/CS increased splenic growth of CFU-GEMM, BFU-E, and CFU-E colonies by 28% to 39% versus LCHS alone. Seven days after LCHS/CS, splenic HPCs increased from 0.60% to 1.12 % compared with naïve animals. After LCHS/CS, both BMP4 and EPO expression increased significantly in the spleen. Splenic EPO receptor (EPOr) expression decreased after LCHS/CS in the presence of a persistent moderate anemia. CONCLUSION Extramedullary erythropoiesis, manifest by increased splenic weight, splenic erythroid colony growth, splenic HPCs, BMP4, and EPO expression, is present in the spleen after LCHS/CS. Splenic EPOr expression was significantly decreased after LCHS/CS. Extramedullary erythropoiesis may play a key role in identifying new therapies to aid the recovery from acute anemia after severe trauma and chronic stress.
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16
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Baksi S, Tripathi AK, Singh N. Alpha-synuclein modulates retinal iron homeostasis by facilitating the uptake of transferrin-bound iron: Implications for visual manifestations of Parkinson's disease. Free Radic Biol Med 2016; 97:292-306. [PMID: 27343690 PMCID: PMC4996775 DOI: 10.1016/j.freeradbiomed.2016.06.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 06/17/2016] [Accepted: 06/21/2016] [Indexed: 11/20/2022]
Abstract
Aggregation of α-synuclein (α-syn) in neurons of the substantia nigra is diagnostic of Parkinson's disease (PD), a neuro-motor disorder with prominent visual symptoms. Here, we demonstrate that α-syn, the principal protein involved in the pathogenesis of PD, is expressed widely in the neuroretina, and facilitates the uptake of transferrin-bound iron (Tf-Fe) by retinal pigment epithelial (RPE) cells that form the outer blood-retinal barrier. Absence of α-syn in knock-out mice (α-syn(-/-)) resulted in down-regulation of ferritin in the neuroretina, indicating depletion of cellular iron stores. A similar phenotype of iron deficiency was observed in the spleen, femur, and brain tissue of α-syn(-)(/-) mice, organs that utilize mainly Tf-Fe for their metabolic needs. The liver and kidney, organs that take up significant amounts of non-Tf-bound iron (NTBI), showed minimal change. Evaluation of the underlying mechanism in the human RPE47 cell line suggested a prominent role of α-syn in the uptake of Tf-Fe by modulating the endocytosis and recycling of transferrin (Tf)/transferrin-receptor (TfR) complex. Down-regulation of α-syn in RPE cells by RNAi resulted in the accumulation of Tf/TfR complex in common recycling endosomes (CREs), indicating disruption of recycling to the plasma membrane. Over-expression of exogenous α-syn in RPE cells, on the other hand, up-regulated ferritin and TfR expression. Interestingly, exposure to exogenous iron increased membrane association and co-localization of α-syn with TfR, supporting its role in iron uptake by the Tf/TfR complex. Together with our observations indicating basolateral expression of α-syn and TfR on RPE cells in vivo, this study reveals a novel function of α-syn in the uptake of Tf-Fe by the neuroretina. It is likely that retinal iron dyshomeostasis due to impaired or altered function of α-syn contributes to the visual symptoms associated with PD.
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Affiliation(s)
- Shounak Baksi
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ajai K Tripathi
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Neena Singh
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
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17
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Mehta K, Busbridge M, Renshaw D, Evans RW, Farnaud S, Patel VB. Characterization of hepcidin response to holotransferrin in novel recombinant TfR1 HepG2 cells. Blood Cells Mol Dis 2016; 61:37-45. [PMID: 27667164 DOI: 10.1016/j.bcmd.2016.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 12/14/2022]
Abstract
Hepcidin is the key regulator of systemic iron homeostasis. The iron-sensing mechanisms and the role of intracellular iron in modulating hepatic hepcidin secretion are unclear. Therefore, we created a novel cell line, recombinant-TfR1 HepG2, expressing iron-response-element-independent TFRC mRNA to promote cellular iron-overload and examined the effect of excess holotransferrin (5g/L) on cell-surface TfR1, iron content, hepcidin secretion and mRNA expressions of TFRC, HAMP, SLC40A1, HFE and TFR2. Results showed that the recombinant cells exceeded levels of cell-surface TfR1 in wild-type cells under basal (2.8-fold; p<0.03) and holotransferrin-supplemented conditions for 24h and 48h (4.4- and 7.5-fold, respectively; p<0.01). Also, these cells showed higher intracellular iron content than wild-type cells under basal (3-fold; p<0.03) and holotransferrin-supplemented conditions (6.6-fold at 4h; p<0.01). However, hepcidin secretion was not higher than wild-type cells. Moreover, holotransferrin treatment to recombinant cells did not elevate HAMP responses compared to untreated or wild-type cells. In conclusion, increased intracellular iron content in recombinant cells did not increase hepcidin responses compared to wild-type cells, resembling hemochromatosis. Furthermore, TFR2 expression altered within 4h of treatment, while HFE expression altered later at 24h and 48h, suggesting that TFR2 may function prior to HFE in HAMP regulation.
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Affiliation(s)
- Kosha Mehta
- Department of Biomedical Sciences, University of Westminster, London, UK
| | - Mark Busbridge
- Department of Clinical Biochemistry, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Derek Renshaw
- Faculty of Health & Life Sciences, Coventry University, Coventry, UK
| | - Robert W Evans
- School of Engineering and Design, Brunel University, London, UK
| | | | - Vinood B Patel
- Department of Biomedical Sciences, University of Westminster, London, UK.
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Brückl D, Kamhieh-Milz S, Kamhieh-Milz J, Salama A. Efficacy and safety of erythrocytapheresis and low-dose erythropoietin for treatment of hemochromatosis. J Clin Apher 2016; 32:170-174. [DOI: 10.1002/jca.21477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 05/04/2016] [Accepted: 05/18/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Dorothea Brückl
- Institute of Transfusion Medicine, Charité University Medicine Berlin; Berlin 13353 Germany
| | - Sundrela Kamhieh-Milz
- Institute of Transfusion Medicine, Charité University Medicine Berlin; Berlin 13353 Germany
| | - Julian Kamhieh-Milz
- Institute of Transfusion Medicine, Charité University Medicine Berlin; Berlin 13353 Germany
| | - Abdulgabar Salama
- Institute of Transfusion Medicine, Charité University Medicine Berlin; Berlin 13353 Germany
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Doty RT, Phelps SR, Shadle C, Sanchez-Bonilla M, Keel SB, Abkowitz JL. Coordinate expression of heme and globin is essential for effective erythropoiesis. J Clin Invest 2015; 125:4681-91. [PMID: 26551679 DOI: 10.1172/jci83054] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/08/2015] [Indexed: 01/27/2023] Open
Abstract
Erythropoiesis requires rapid and extensive hemoglobin production. Heme activates globin transcription and translation; therefore, heme synthesis must precede globin synthesis. As free heme is a potent inducer of oxidative damage, its levels within cellular compartments require stringent regulation. Mice lacking the heme exporter FLVCR1 have a severe macrocytic anemia; however, the mechanisms that underlie erythropoiesis dysfunction in these animals are unclear. Here, we determined that erythropoiesis failure occurs in these animals at the CFU-E/proerythroblast stage, a point at which the transferrin receptor (CD71) is upregulated, iron is imported, and heme is synthesized--before ample globin is produced. From the CFU-E/proerythroblast (CD71(+) Ter119(-) cells) stage onward, erythroid progenitors exhibited excess heme content, increased cytoplasmic ROS, and increased apoptosis. Reducing heme synthesis in FLVCR1-defient animals via genetic and biochemical approaches improved the anemia, implying that heme excess causes, and is not just associated with, the erythroid marrow failure. Expression of the cell surface FLVCR1 isoform, but not the mitochondrial FLVCR1 isoform, restored normal rbc production, demonstrating that cellular heme export is essential. Together, these studies provide insight into how heme is regulated to allow effective erythropoiesis, show that erythropoiesis fails when heme is excessive, and emphasize the importance of evaluating Ter119(-) erythroid cells when studying erythroid marrow failure in murine models.
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20
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Relationship of Baseline Hemoglobin Level with Serum Ferritin, Postphlebotomy Hemoglobin Changes, and Phlebotomy Requirements among HFE C282Y Homozygotes. BIOMED RESEARCH INTERNATIONAL 2015; 2015:241784. [PMID: 26380265 PMCID: PMC4563067 DOI: 10.1155/2015/241784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/17/2015] [Indexed: 11/17/2022]
Abstract
Objectives. We aimed to examine whether baseline hemoglobin levels in C282Y-homozygous patients are related to the degree of serum ferritin (SF) elevation and whether patients with different baseline hemoglobin have different phlebotomy requirements. Methods. A total of 196 patients (124 males and 72 females) who had undergone therapeutic phlebotomy and had SF and both pre- and posttreatment hemoglobin values were included in the study. Results. Bivariate correlation analysis suggested that baseline SF explains approximately 6 to 7% of the variation in baseline hemoglobin. The results also showed that males who had higher (≥150 g/L) baseline hemoglobin levels had a significantly greater reduction in their posttreatment hemoglobin despite requiring fewer phlebotomies to achieve iron depletion than those who had lower (<150 g/L) baseline hemoglobin, regardless of whether baseline SF was below or above 1000 µg/L. There were no significant differences between hemoglobin subgroups regarding baseline and treatment characteristics, except for transferrin saturation between male subgroups with SF above 1000 µg/L. Similar differences were observed when females with higher (≥138 g/L) baseline hemoglobin were compared with those with lower (<138 g/L) baseline hemoglobin. Conclusion. Dividing C282Y-homozygous patients into just two subgroups according to the degree of baseline SF elevation may obscure important subgroup variations.
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Ye K, Cao C, Lin X, O'Brien KO, Gu Z. Natural selection on HFE in Asian populations contributes to enhanced non-heme iron absorption. BMC Genet 2015; 16:61. [PMID: 26054392 PMCID: PMC4460683 DOI: 10.1186/s12863-015-0223-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 06/01/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND HFE, a major regulator of iron (Fe) homeostasis, has been suggested to be under positive selection in both European and Asian populations. While the genetic variant under selection in Europeans (a non-synonymous mutation, C282Y) has been relatively well-studied, the adaptive variant in Asians and its functional consequences are still unknown. Identifying the adaptive HFE variants in Asians will not only elucidate the evolutionary history and the genetic basis of population difference in Fe status, but also assist the future practice of genome-informed dietary recommendation. RESULTS Using data from the International HapMap Project, we confirmed the signatures of positive selection on HFE in Asian populations and identified a candidate adaptive haplotype that is common in Asians (52.35-54.71%) but rare in Europeans (5.98%) and Africans (4.35%). The T allele at tag SNP rs9366637 (C/T) captured 95.8% of this Asian-common haplotype. A significantly reduced HFE expression was observed in individuals carrying T/T at rs9366637 compared to C/C and C/T, indicating a possible role of gene regulation in adaptation. We recruited 57 women of Asian descent and measured Fe absorption using stable isotopes in those homozygous at rs9366637. We observed a 22% higher absorption in women homozygous for the Asian-common haplotype (T/T) compared to the control genotype (C/C). Additionally, compared with a group of age-matched Caucasian women, Asian women exhibited significantly elevated Fe absorption. CONCLUSIONS Our results indicate parallel adaptation of HFE gene in Europeans and Asians with different genetic variants. Moreover, natural selection on HFE may have contributed to elevated Fe absorption in Asians. This study regarding population differences in Fe homeostasis has significant medical impact as high Fe level has been linked to an increased disease risk of metabolic syndromes.
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Affiliation(s)
- Kaixiong Ye
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
| | - Chang Cao
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
| | - Xu Lin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate University of the Chinese Academy of Sciences, Shanghai, China.
| | | | - Zhenglong Gu
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
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Holmgren G, Synnergren J, Bogestål Y, Améen C, Åkesson K, Holmgren S, Lindahl A, Sartipy P. Identification of novel biomarkers for doxorubicin-induced toxicity in human cardiomyocytes derived from pluripotent stem cells. Toxicology 2014; 328:102-11. [PMID: 25529476 PMCID: PMC4326176 DOI: 10.1016/j.tox.2014.12.018] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 01/17/2023]
Abstract
Doxorubicin is a chemotherapeutic agent indicated for the treatment of a variety of cancer types, including leukaemia, lymphomas, and many solid tumours. The use of doxorubicin is, however, associated with severe cardiotoxicity, often resulting in early discontinuation of the treatment. Importantly, the toxic symptoms can occur several years after the termination of the doxorubicin administration. In this study, the toxic effects of doxorubicin exposure have been investigated in cardiomyocytes derived from human embryonic stem cells (hESC). The cells were exposed to different concentrations of doxorubicin for up to 2 days, followed by a 12 day recovery period. Notably, the cell morphology was altered during drug treatment and the cells showed a reduced contractile ability, most prominent at the highest concentration of doxorubicin at the later time points. A general cytotoxic response measured as Lactate dehydrogenase leakage was observed after 2 days’ exposure compared to the vehicle control, but this response was absent during the recovery period. A similar dose-dependant pattern was observed for the release of cardiac specific troponin T (cTnT) after 1 day and 2 days of treatment with doxorubicin. Global transcriptional profiles in the cells revealed clusters of genes that were differentially expressed during doxorubicin exposure, a pattern that in some cases was sustained even throughout the recovery period, suggesting that these genes could be used as sensitive biomarkers for doxorubicin-induced toxicity in human cardiomyocytes. The results from this study show that cTnT release can be used as a measurement of acute cardiotoxicity due to doxorubicin. However, for the late onset of doxorubicin-induced cardiomyopathy, cTnT release might not be the most optimal biomarker. As an alternative, some of the genes that we identified as differentially expressed after doxorubicin exposure could serve as more relevant biomarkers, and may also help to explain the cellular mechanisms behind the late onset apoptosis associated with doxorubicin-induced cardiomyopathy.
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Affiliation(s)
- Gustav Holmgren
- Systems Biology Research Center, School of Bioscience, University of Skövde, Box 408, Kanikegränd 3A, SE-541 28 Skövde, Sweden; Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Jane Synnergren
- Systems Biology Research Center, School of Bioscience, University of Skövde, Box 408, Kanikegränd 3A, SE-541 28 Skövde, Sweden.
| | - Yalda Bogestål
- Systems Biology Research Center, School of Bioscience, University of Skövde, Box 408, Kanikegränd 3A, SE-541 28 Skövde, Sweden
| | - Caroline Améen
- Takara Bio Europe AB (former Cellectis AB), Arvid Wallgrens Backe 20, SE-413 46 Gothenburg, Sweden.
| | - Karolina Åkesson
- Takara Bio Europe AB (former Cellectis AB), Arvid Wallgrens Backe 20, SE-413 46 Gothenburg, Sweden.
| | - Sandra Holmgren
- Takara Bio Europe AB (former Cellectis AB), Arvid Wallgrens Backe 20, SE-413 46 Gothenburg, Sweden.
| | - Anders Lindahl
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Peter Sartipy
- Systems Biology Research Center, School of Bioscience, University of Skövde, Box 408, Kanikegränd 3A, SE-541 28 Skövde, Sweden; Takara Bio Europe AB (former Cellectis AB), Arvid Wallgrens Backe 20, SE-413 46 Gothenburg, Sweden.
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23
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Guimarães JS, Cominal JG, Silva-Pinto AC, Olbina G, Ginzburg YZ, Nandi V, Westerman M, Rivella S, de Souza AM. Altered erythropoiesis and iron metabolism in carriers of thalassemia. Eur J Haematol 2014; 94:511-8. [PMID: 25307880 DOI: 10.1111/ejh.12464] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2014] [Indexed: 12/13/2022]
Abstract
The thalassemia syndromes (α- and β-thalassemia) are the most common and frequent disorders associated with ineffective erythropoiesis. Imbalance of α- or β-globin chain production results in impaired red blood cell synthesis, anemia, and more erythroid progenitors in the blood stream. While patients affected by these disorders show definitive altered parameters related to erythropoiesis, the relationship between the degree of anemia, altered erythropoiesis, and dysfunctional iron metabolism has not been investigated in both α-thalassemia carriers (ATC) and β-thalassemia carriers (BTC). Here, we demonstrate that ATC have a significantly reduced hepcidin and increased soluble transferrin receptor levels but relatively normal hematological findings. In contrast, BTC have several hematological parameters significantly different from controls, including increased soluble transferrin receptor and erythropoietin levels. These changes in both groups suggest an altered balance between erythropoiesis and iron metabolism. The index sTfR/log ferritin and (hepcidin/ferritin)/sTfR are, respectively, increased and reduced relative to controls, proportional to the severity of each thalassemia group. In conclusion, we showed in this study, for the first time in the literature, that thalassemia carriers have altered iron metabolism and erythropoiesis.
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Affiliation(s)
- Jacqueline S Guimarães
- Laboratório de Hematologia Clínica, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.,The Strauss Thalassemia Laboratory, Pediatric Hematology-Oncology, Weill Medical College of Cornell University, New York, NY, USA
| | - Juçara G Cominal
- Laboratório de Hematologia Clínica, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Ana Cristina Silva-Pinto
- Centro Regional de Hemoterapia de Ribeirão Preto, Departamento de Medicina Interna, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | | | | | | | - Stefano Rivella
- The Strauss Thalassemia Laboratory, Pediatric Hematology-Oncology, Weill Medical College of Cornell University, New York, NY, USA
| | - Ana Maria de Souza
- Laboratório de Hematologia Clínica, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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Sangaré L, van Eijk AM, ter Kuile FO, Walson J, Stergachis A. The association between malaria and iron status or supplementation in pregnancy: a systematic review and meta-analysis. PLoS One 2014; 9:e87743. [PMID: 24551064 PMCID: PMC3925104 DOI: 10.1371/journal.pone.0087743] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 12/27/2013] [Indexed: 12/20/2022] Open
Abstract
Introduction Malaria prevention and iron supplementation are associated with improved maternal and infant outcomes. However, evidence from studies in children suggests iron may adversely modify the risk of malaria. We reviewed the evidence in pregnancy of the association between malaria and markers of iron status, iron supplementation or parenteral treatment. Methods and Findings We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Global Health Library, and the Malaria in Pregnancy library to identify studies that investigated the association between iron status, iron treatment or supplementation during pregnancy and malaria. Thirty one studies contributed to the analysis; 3 experimental and 28 observational studies. Iron supplementation was not associated with an increased risk of P. falciparum malaria during pregnancy or delivery in Africa (summary Relative Risk = 0.89, 95% Confidence Interval (CI) 0.66–1.20, I2 = 78.8%, 5 studies). One study in Asia reported an increased risk of P. vivax within 30 days of iron supplementation (e.g. adjusted Hazard Ratio = 1.75, 95% CI 1.14–2.70 for 1–15 days), but not after 60 days. Iron deficiency (based on ferritin and C-reactive protein) was associated with lower odds for malaria infection (summary Odds Ratio = 0.35, 0.24–0.51, I2 = 59.2%, 5 studies). With the exception of the acute phase protein ferritin, biomarkers of iron deficiency were generally not associated with malaria infection. Conclusions Iron supplementation was associated with a temporal increase in P vivax, but not with an increased risk of P. falciparum; however, data are insufficient to rule out the potential for an increased risk of P. falciparum. Iron deficiency was associated with a decreased malaria risk in pregnancy only when measured with ferritin. Until there is more evidence, it is prudent to provide iron in combination with malaria prevention during pregnancy.
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Affiliation(s)
- Laura Sangaré
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Bioengineering, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - Anna Maria van Eijk
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Feiko O. ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Judd Walson
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Medicine and Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - Andy Stergachis
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
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25
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Vignjević S, Budeč M, Marković D, Dikić D, Mitrović O, Mojsilović S, Durić SV, Koko V, Cokić BB, Cokić V, Jovčić G. Chronic psychological stress activates BMP4-dependent extramedullary erythropoiesis. J Cell Mol Med 2013; 18:91-103. [PMID: 24283209 PMCID: PMC3916121 DOI: 10.1111/jcmm.12167] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/16/2013] [Indexed: 01/14/2023] Open
Abstract
Psychological stress affects different physiological processes including haematopoiesis. However, erythropoietic effects of chronic psychological stress remain largely unknown. The adult spleen contains a distinct microenvironment favourable for rapid expansion of erythroid progenitors in response to stressful stimuli, and emerging evidence suggests that inappropriate activation of stress erythropoiesis may predispose to leukaemic transformation. We used a mouse model to study the influence of chronic psychological stress on erythropoiesis in the spleen and to investigate potential mediators of observed effects. Adult mice were subjected to 2 hrs daily restraint stress for 7 or 14 consecutive days. Our results showed that chronic exposure to restraint stress decreased the concentration of haemoglobin in the blood, elevated circulating levels of erythropoietin and corticosterone, and resulted in markedly increased number of erythroid progenitors and precursors in the spleen. Western blot analysis revealed significantly decreased expression of both erythropoietin receptor and glucocorticoid receptor in the spleen of restrained mice. Furthermore, chronic stress enhanced the expression of stem cell factor receptor in the red pulp. Moreover, chronically stressed animals exhibited significantly increased expression of bone morphogenetic protein 4 (BMP4) in the red pulp as well as substantially enhanced mRNA expression levels of its receptors in the spleen. These findings demonstrate for the first time that chronic psychological stress activates BMP4-dependent extramedullary erythropoiesis and leads to the prolonged activation of stress erythropoiesis pathways. Prolonged activation of these pathways along with an excessive production of immature erythroid cells may predispose chronically stressed subjects to a higher risk of leukaemic transformation.
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Affiliation(s)
- Sanja Vignjević
- Institute for Medical Research, University of Belgrade, Belgrade, Serbia
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26
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Chait Y, Horowitz J, Nichols B, Shrestha RP, Hollot CV, Germain MJ. Control-relevant erythropoiesis modeling in end-stage renal disease. IEEE Trans Biomed Eng 2013; 61:658-64. [PMID: 24235247 DOI: 10.1109/tbme.2013.2286100] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anemia is prevalent in end-stage renal disease (ESRD). The discovery of recombinant human erythropoietin (rHuEPO) over 30 years ago has shifted the treatment of anemia for patients on dialysis from blood transfusions to rHuEPO therapy. Many anemia management protocols (AMPs) used by clinicians comprise a set of experience-based rules for weekly-to-monthly titration of rHuEPO doses based on hemoglobin (Hb) measurements. In order to facilitate the design of an AMP using model-based feedback control theory, we present a physiologically relevant erythropoiesis model and demonstrate its applicability using clinical data.
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27
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Haunhorst P, Hanschmann EM, Bräutigam L, Stehling O, Hoffmann B, Mühlenhoff U, Lill R, Berndt C, Lillig CH. Crucial function of vertebrate glutaredoxin 3 (PICOT) in iron homeostasis and hemoglobin maturation. Mol Biol Cell 2013; 24:1895-903. [PMID: 23615448 PMCID: PMC3681695 DOI: 10.1091/mbc.e12-09-0648] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Vertebrate glutaredoxin 3 (PICOT) is essential for the maturation of the heme cofactor of hemoglobin through its essential functions in iron homeostasis. The data suggest an evolutionarily conserved role of cytosolic monothiol multidomain Grxs in cellular iron metabolism pathways. The mechanisms by which eukaryotic cells handle and distribute the essential micronutrient iron within the cytosol and other cellular compartments are only beginning to emerge. The yeast monothiol multidomain glutaredoxins (Grx) 3 and 4 are essential for both transcriptional iron regulation and intracellular iron distribution. Despite the fact that the mechanisms of iron metabolism differ drastically in fungi and higher eukaryotes, the glutaredoxins are conserved, yet their precise function in vertebrates has remained elusive. Here we demonstrate a crucial role of the vertebrate-specific monothiol multidomain Grx3 (PICOT) in cellular iron homeostasis. During zebrafish embryonic development, depletion of Grx3 severely impairs the maturation of hemoglobin, the major iron-consuming process. Silencing of human Grx3 expression in HeLa cells decreases the activities of several cytosolic Fe/S proteins, for example, iron-regulatory protein 1, a major component of posttranscriptional iron regulation. As a consequence, Grx3-depleted cells show decreased levels of ferritin and increased levels of transferrin receptor, features characteristic of cellular iron starvation. Apparently, Grx3-deficient cells are unable to efficiently use iron, despite unimpaired cellular iron uptake. These data suggest an evolutionarily conserved role of cytosolic monothiol multidomain glutaredoxins in cellular iron metabolism pathways, including the biogenesis of Fe/S proteins and hemoglobin maturation.
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Affiliation(s)
- Petra Haunhorst
- Institute for Clinical Cytobiology and Cytopathology, Faculty of Medicine, Philipps-Universität, 35037 Marburg, Germany
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28
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D'Anna MC, Roque ME. Physiological focus on the erythropoietin-hepcidin-ferroportin axis. Can J Physiol Pharmacol 2013; 91:338-45. [PMID: 23656253 DOI: 10.1139/cjpp-2012-0214] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
To analyze the interconnection between erythropoiesis and iron metabolism, one of the issues raised in this study was to know iron bioavailability under physiopathological conditions. Our aim was to understand the functional axis response composed of erythropoietin (Epo)-hepcidin-ferroportin (FPN), when 2 dysfunctional states coexist, using an animal model of iron overload followed by hypoxia. FPN and prohepcidin were assessed by immunohistochemistry using rabbit anti-mouse FPN polyclonal and prohepcidin monoclonal antibodies. Goat-labeled polymer - horseradish peroxidase anti-rabbit EnVision + System (DAB) was used as the secondary antibody. Epo levels were measured by ELISA. Tissue iron was studied by Prussian blue iron staining. Erythropoietic response was assessed using conventional hematological tests. Iron overload increased prohepcidin that remained high in hypoxia, coexisting with high levels of Epo in hypoxia, with or without iron overload. In hypoxia, FPN was clearly evident in reticuloendothelial macrophages, more than in hypoxia with iron overload. Interestingly, duodenal FPN was clearly identified on the basolateral membrane in hypoxia, with or without iron overload. Our data indicate that 2 signals could induce the cell-specific response as follows: (i) iron signal, induced prohepcidin, which reduced reticuloendothelial FPN and reduced iron availability; and (ii) hypoxia signal, stimulated Epo, which affected iron absorption by stabilizing duodenal FPN and allowed iron supply to erythropoiesis independently of store size.
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Affiliation(s)
- María Cecilia D'Anna
- Laboratory of Human Physiology, Department of Biology, Biochemistry and Pharmacy, San Juan 670, Universidad Nacional del Sur, Bahía Blanca, Argentina
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29
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Capobianco A, Rovere-Querini P. Endometriosis, a disease of the macrophage. Front Immunol 2013; 4:9. [PMID: 23372570 PMCID: PMC3556586 DOI: 10.3389/fimmu.2013.00009] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/07/2013] [Indexed: 12/14/2022] Open
Abstract
Endometriosis, a common cause of pelvic pain and female infertility, depends on the growth of vascularized endometrial tissue at ectopic sites. Endometrial fragments reach the peritoneal cavity during the fertile years: local cues decide whether they yield endometriotic lesions. Macrophages are recruited at sites of hypoxia and tissue stress, where they clear cell debris and heme-iron and generate pro-life and pro-angiogenesis signals. Macrophages are abundant in endometriotic lesions, where are recruited and undergo alternative activation. In rodents macrophages are required for lesions to establish and to grow; bone marrow-derived Tie-2 expressing macrophages specifically contribute to lesions neovasculature, possibly because they concur to the recruitment of circulating endothelial progenitors, and sustain their survival and the integrity of the vessel wall. Macrophages sense cues (hypoxia, cell death, iron overload) in the lesions and react delivering signals to restore the local homeostasis: their action represents a necessary, non-redundant step in the natural history of the disease. Endometriosis may be due to a misperception of macrophages about ectopic endometrial tissue. They perceive it as a wound, they activate programs leading to ectopic cell survival and tissue vascularization. Clearing this misperception is a critical area for the development of novel medical treatments of endometriosis, an urgent and unmet medical need.
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Affiliation(s)
- Annalisa Capobianco
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute Milan, Italy
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30
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Nichols B, Shrestha RP, Horowitz J, Hollot CV, Germain MJ, Gaweda AE, Chait Y. Simplification of an erythropoiesis model for design of anemia management protocols in end stage renal disease. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2011:83-6. [PMID: 22254256 DOI: 10.1109/iembs.2011.6089902] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Many end stage renal disease (ESRD) patients suffer from anemia due to insufficient endogenous production of erythropoietin (EPO). The discovery of recombinant human EPO (rHuEPO) over 30 years ago has shifted the treatment of anemia for patients on dialysis from blood transfusions to rHuEPO therapy. Many anemia management protocols (AMPs) used by clinicians comprise a set of experience-based rules for weekly-to-monthly titration of rHuEPO doses based on hemoglobin (Hgb) measurements. In order to facilitate the design of an AMP based on formal control design methods, we present a physiologically-relevant erythropoiesis model, and show that its nonlinear dynamics can be approximated using a static nonlinearity, a step that greatly simplifies AMP design. We demonstrate applicability of our results using clinical data.
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Affiliation(s)
- B Nichols
- Departments, UMass, Amherst, MA 01003, USA
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31
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Berglund S, Lönnerdal B, Westrup B, Domellöf M. Effects of iron supplementation on serum hepcidin and serum erythropoietin in low-birth-weight infants. Am J Clin Nutr 2011; 94:1553-61. [PMID: 22071701 DOI: 10.3945/ajcn.111.013938] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The iron-regulatory hormone hepcidin has not been studied in infants, who experience large physiologic changes in iron status. OBJECTIVE The objective was to study hepcidin and erythropoietin and their correlation with iron status in iron-replete and iron-deficient low-birth-weight (LBW) infants-a group at particular risk of iron deficiency (ID). DESIGN We randomly assigned 285 otherwise healthy LBW infants to receive, from 6 wk to 6 mo of age, 3 doses of iron supplements: 0 (placebo), 1, or 2 mg/kg daily. Hepcidin, erythropoietin, hemoglobin, and variables of iron status were analyzed. RESULTS Serum hepcidin did not change over time in the placebo group, despite a rapid decrease in serum ferritin. In iron-supplemented infants, hepcidin increased significantly, reaching a mean (±SD) concentration of 19.2 ± 2.5 ng/mL in the 2-mg/kg group compared with 13.0 ± 2.6 ng/mL in the placebo group at age 6 mo (P < 0.001). The difference was even larger between iron-deficient and iron-replete infants. Hepcidin was independently positively correlated with ferritin at all ages and was negatively correlated with the transferrin receptor concentration at age 6 wk and with transferrin at age 6 mo. Erythropoietin was initially similar between groups but decreased significantly in iron-supplemented infants. In addition to being negatively correlated with hemoglobin, it was also independently negatively correlated with indicators of iron status. CONCLUSIONS Hepcidin is closely associated with iron status and may be a useful indicator of iron stores and ID in infants. Erythropoietin is negatively correlated with iron status, which suggests a feedback mechanism that needs further study. This trial is registered at clinicaltrials.gov as NCT00558454.
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Affiliation(s)
- Staffan Berglund
- Department of Clinical Sciences, Pediatrics, Umeå University, Sweden.
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β-thalassemia: a model for elucidating the dynamic regulation of ineffective erythropoiesis and iron metabolism. Blood 2011; 118:4321-30. [PMID: 21768301 DOI: 10.1182/blood-2011-03-283614] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
β-thalassemia is a disease characterized by anemia and is associated with ineffective erythropoiesis and iron dysregulation resulting in iron overload. The peptide hormone hepcidin regulates iron metabolism, and insufficient hepcidin synthesis is responsible for iron overload in minimally transfused patients with this disease. Understanding the crosstalk between erythropoiesis and iron metabolism is an area of active investigation in which patients with and models of β-thalassemia have provided significant insight. The dependence of erythropoiesis on iron presupposes that iron demand for hemoglobin synthesis is involved in the regulation of iron metabolism. Major advances have been made in understanding iron availability for erythropoiesis and its dysregulation in β-thalassemia. In this review, we describe the clinical characteristics and current therapeutic standard in β-thalassemia, explore the definition of ineffective erythropoiesis, and discuss its role in hepcidin regulation. In preclinical experiments using interventions such as transferrin, hepcidin agonists, and JAK2 inhibitors, we provide evidence of potential new treatment alternatives that elucidate mechanisms by which expanded or ineffective erythropoiesis may regulate iron supply, distribution, and utilization in diseases such as β-thalassemia.
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33
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Crosstalk between Erythropoiesis and Iron Metabolism. Adv Hematol 2010; 2010. [PMID: 20862206 PMCID: PMC2938435 DOI: 10.1155/2010/317095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 07/14/2010] [Indexed: 01/13/2023] Open
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