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Shimizu MR, de Groot TM, Twining PK, Kobes T, Ferrone M, Raskin K, Jutte PC, Cohen S, Lozano-Calderon S, Groot OQ, Schwab JH. Factors associated with skeletal-related events in patients with bone metastatic melanoma: A retrospective study of 481 patients. J Surg Oncol 2024. [PMID: 38881406 DOI: 10.1002/jso.27731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/07/2024] [Accepted: 06/01/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Metastatic bone disease is estimated to develop in up to 17% of patients with melanoma, compromising skeleton integrity resulting in skeletal-related events (SREs), which impair quality of life and reduce survival. The objective of the study was to investigate (1) the proportion of melanoma patients developing SREs following diagnosis of bone metastasis and (2) the predictors for SREs in this patient cohort. METHODS Four hundred and eighty-one patients with bone metastatic melanoma from two tertiary centers in the United States from 2008 to 2018 were included. The primary outcome was 90-day and 1-year occurrence of a SRE, including pathological fractures of bones, cord compression, hypercalcemia, radiotherapy, and surgery. Fine-Gray regression analysis was performed for overall SREs and pathological fracture, with death as a competing risk. RESULTS By 1-year, 52% (258/481) of patients experienced SREs, and 28% (137/481) had a pathological fracture. At 90-day, lytic lesions, bone pain, elevated calcium and absolute lymphocyte, and decreased albumin and hemoglobin were associated with higher SRE risk. The same factors, except for decreased hemoglobin, were shown to predict development of SREs at 1-year. CONCLUSION The high incidence of SREs and pathological fractures warrants vigilance using the identified factors in this study and preventative measures during clinical oncological care.
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Affiliation(s)
- Michelle R Shimizu
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Tom M de Groot
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Orthopedics, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter K Twining
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Tim Kobes
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marco Ferrone
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kevin Raskin
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul C Jutte
- Department of Orthopedics, University Medical Center Groningen, Groningen, The Netherlands
| | - Sonia Cohen
- Department of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Olivier Q Groot
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joseph H Schwab
- Department of Orthopedics, Massachusetts General Hospital, Boston, Massachusetts, USA
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Gursoy V, Sadri S, Kucukelyas HD, Hunutlu FC, Pinar IE, Yegen ZS, Alkış N, Ersal T, Ali R, Ozkocaman V, Ozkalemkas F. HALP score as a novel prognostic factor for patients with myelodysplastic syndromes. Sci Rep 2024; 14:13843. [PMID: 38879594 PMCID: PMC11180126 DOI: 10.1038/s41598-024-64166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 06/05/2024] [Indexed: 06/19/2024] Open
Abstract
Myelodysplastic syndrome (MDS) is a heterogeneous spectrum of clonal hematopoietic disorders with varying degrees of cytopenia and morphologic dysplasia. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a prognostic marker in several types of malignant tumors. Prognostic value of HALP score remains unclear for MDS. To determine the prognostic value of baseline HALP score in MDS. We retrospectively analyzed data from 130 newly diagnosed MDS patients evaluated and classified under HALP score. By the receiver operating characteristic (ROC) analysis, the optimal cut-off value of HALP was > 67.5 in predicting mortality. Patients were divided into two groups: with low and high HALP scores, and the characteristics were compared between both groups. Patients' median age was 68 (19-84) years, and 79 (60.8%) were male. Higher HALP score was detected in MDS patients with intermediate-risk under IPSS score, and at high and very high risks under IPSS-R score, and those receiving azacitidine (AZA) treatment. The survival rates of those with a HALP score > 67.5 were significantly lower than those with low HALP score at 17.77 ± 3.98 (median ± SE) (p < 0.001). The 3-, 5- and 10-years survival rates of individuals with HALP scores > 67.5 were found as 25, 18, and 11%, respectively. Median overall survival (OS) was also determined as 33.10 (95% CI 16.34-49.88) months by the Kaplan-Meier method. HALP score has shown an ability to be a useful prognostic biomarker in various cancers, including MDS. The meaningful cut-off value of HALP is disease-specific and largely study-specific. High HALP score is associated with unfavorable clinicopathological characteristics. Also, it may be useful in predicting OS and mortality of MDS.
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Affiliation(s)
- Vildan Gursoy
- Department of Hematology, Bursa City Hospital, Bursa, Turkey.
| | - Sevil Sadri
- Department of Hematology, Bursa City Hospital, Bursa, Turkey
| | | | | | | | | | - Nihan Alkış
- Department of Hematology, Bursa City Hospital, Bursa, Turkey
| | - Tuba Ersal
- Department of Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Ridvan Ali
- Department of Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Vildan Ozkocaman
- Department of Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Fahir Ozkalemkas
- Department of Hematology, Uludag University Medical Faculty, Bursa, Turkey
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Chen S, Xiao J, Cai W, Lu X, Liu C, Dong Y, Zheng Y, Song G, Sun Q, Wang H, Xiao Z. Association of the systemic immune-inflammation index with anemia: a population-based study. Front Immunol 2024; 15:1391573. [PMID: 38799419 PMCID: PMC11116595 DOI: 10.3389/fimmu.2024.1391573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Background Inflammation has been reported to be related to anemia. As a novel inflammatory marker, Systemic immune-inflammation index (SII) has not been studied with Anemia. The aim of this study was to investigate the possible relationship between SII and anemia. Methods This retrospective cross-sectional survey was conducted using data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) population. In total, 19851 American adults aged ≥18 years were included. SII was calculated as the platelet count×neutrophil count/lymphocyte count. Anemia was defined as hemoglobin (Hgb) levels of < 13 g/dL in males and < 12 g/dL in females. Logistic regression analyses, subgroup analyses and sensitivity analyses were performed to investigate the relationship between SII and anemia. Results Our study included a total of 19851 patients, of which 1501 (7.6%) had anemia. After adjusting for all covariates, the multivariate logistic regression analysis showed that a higher SII (In-transform) level was associated with increased likelihood of anemia (OR=1.51, 95% CI: 1.36-1.68, P<0.001). The association between SII and anemia exhibited a nonlinear manner. The positive correlation between SII and anemia was related to the severity of anemia. Subgroup analysis showed that there was no significant dependence on age, family income, body mass index, hypertension, kidney disease and cancer except gender on this positive association. Furthermore, sensitivity analyses confirmed the robustness of our results. Conclusion Our study demonstrated that SII was positively associated with anemia especially among female participants. And this positive correlation was related to the severity of anemia. Further large-scale prospective studies are still needed to analyze the role of SII in anemia.
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Affiliation(s)
- Shuying Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Jigang Xiao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Wenyu Cai
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Xulin Lu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Chenxi Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yan Dong
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yingchun Zheng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ge Song
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Qi Sun
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Huijun Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Zhijian Xiao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- StateTianjin Institutes of Health Science, Tianjin, China
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Ardinata D, Sari Harahap N, Lubis NDA, Nasution TA. Exploring the moderating effects of SIRT1 and gene polymorphisms rs7895833 on the relationship between hemoglobin levels and physical frailty in elderly adults with comorbid chronic diseases: A moderated mediation analysis. F1000Res 2024; 12:510. [PMID: 38706642 PMCID: PMC11066533 DOI: 10.12688/f1000research.133517.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/07/2024] Open
Abstract
Background Relationship age, hemoglobin, and physical frailty have all been investigated in older people with more than one chronic disease. There has been little analysis of the relationship between hemoglobin, age, physical frailty, plasma levels of Sirtuin1 (SIRT1), and the gene polymorphism (SNP) rs7895833 A>G. The goal of this study was to find out how SIRT1 level, SNP rs7895833, hemoglobin, age, and physical frailty (frail score) are related in older Indonesian adults with comorbid chronic diseases. Methods This was an observational study. Demographic and clinical data were retrieved from the electronic health records of Universitas Sumatera Utara Hospital, Medan, Indonesia. Physical frailty, SIRT1 level, and SNP rs7895833 were measured using an appropriate and valid method. Purposive sampling was used to determine the eligibility of 132 elderly adults from November 2022 to February 2023. Results The indirect effect of hemoglobin on the frail score (FS) through age was negative and significant, according to a conditional mediation analysis (β=-0.0731; p=0.023). Meanwhile, the direct effect of hemoglobin on the FS was negative and not significant (β=0.1632; p=0.052). According to the conditional moderated mediation analysis, the size of the direct effect of age on FS was increased by genotype AG-GG and SIRT1 level (β low=0.2647; p=0.002, β middle=0.2956; p<0.001, and β high=0.319; p<0.001). The size of the conditional indirect effect of Hemoglobin on FS through age was negative and significantly increased by SNP genotype AG-GG and SIRT1 level (β low=-0.0647; p=0.032, β middle=-0.0723; p=0.024, and β high=-0.078; p=0.02). Conclusions Higher plasma levels of SIRT1 and the SNP genotype AG-GG may both contribute to physical frailty in the elderly population. Hemoglobin levels in the blood fall with age, which can negatively impact older persons who already have chronic diseases. However, the interactions between these factors are intricate, requiring more study to completely understand the processes underlying development.
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Affiliation(s)
- Dedi Ardinata
- Department of Physiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatra, Indonesia
| | - Novita Sari Harahap
- Department of Sport Science, Faculty of Sport Science, Universitas Negeri Medan, Medan, North Sumatra, Indonesia
| | - Nenni Dwi Aprianti Lubis
- Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatra, Indonesia
| | - Tetty Aman Nasution
- Department of Microbiology, Universitas Sumatera Utara, Medan, North Sumatra, Indonesia
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Kamvuma K, Hamooya BM, Munsaka S, Masenga SK, Kirabo A. Mechanisms and Cardiorenal Complications of Chronic Anemia in People with HIV. Viruses 2024; 16:542. [PMID: 38675885 PMCID: PMC11053456 DOI: 10.3390/v16040542] [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: 03/12/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Chronic anemia is more prevalent in people living with HIV (PLWH) compared to the general population. The mechanisms that drive chronic anemia in HIV are multifaceted and include functional impairment of hematopoietic stem cells, dysregulation of erythropoietin production, and persistent immune activation. Chronic inflammation from HIV infection adversely affects erythropoiesis, erythrocyte lifespan, and erythropoietin response, leading to a heightened risk of co-infections such as tuberculosis, persistent severe anemia, and increased mortality. Additionally, chronic anemia exacerbates the progression of HIV-associated nephrotoxicity and contributes to cardiovascular risk through immune activation and inflammation. This review highlights the cardinal role of chronic inflammation as a link connecting persistent anemia and cardiovascular complications in PLWH, emphasizing the need for a universal understanding of these interconnected pathways for targeted interventions.
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Affiliation(s)
- Kingsley Kamvuma
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (K.K.); (B.M.H.)
| | - Benson M. Hamooya
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (K.K.); (B.M.H.)
| | - Sody Munsaka
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka P.O Box 50110, Zambia;
| | - Sepiso K. Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (K.K.); (B.M.H.)
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Annet Kirabo
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Center for Immunobiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Institute for Infection, Immunology and Inflammation, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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Iqbal TH, Kennedy N, Dhar A, Ahmed W, Pollock RF. Cost-utility analysis of ferric derisomaltose versus ferric carboxymaltose in patients with inflammatory bowel disease and iron deficiency anemia in England. J Med Econ 2024; 27:392-403. [PMID: 38391240 DOI: 10.1080/13696998.2024.2313932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/31/2024] [Indexed: 02/24/2024]
Abstract
AIMS Anemia is the most common extraintestinal complication of inflammatory bowel disease (IBD), with approximately half of cases caused by iron deficiency (ID). Intravenous iron is the preferred ID anemia (IDA) treatment where oral iron is contraindicated, ineffective or not tolerated, or where ID correction is urgent. The objective was to evaluate the cost-utility of ferric derisomaltose (FDI) versus ferric carboxymaltose (FCM) in patients with IBD and IDA in England, in whom IV iron treatment is preferred. MATERIALS AND METHODS A patient-level simulation model was developed, capturing quality of life (QoL) differences based on SF-36v2 data from the PHOSPHARE-IBD randomized controlled trial, monitoring and incidence of post-infusion hypophosphatemia, and number of iron infusions required. Analyses were conducted over a five-year time horizon from the Department of Health and Social Care (DHSC) perspective, with healthcare provider and societal perspectives adopted in separate analyses. Future costs and effects were discounted at 3.5% per annum and one-way and probabilistic sensitivity analyses were performed. RESULTS FDI increased quality-adjusted life expectancy by 0.075 QALYs versus FCM from 2.57 QALYs to 2.65 QALYs per patient. Patients receiving FDI required 1.63 fewer iron infusions over the five-year time horizon, driving infusion-related cost savings of GBP 496 per patient (GBP 2,188 versus GBP 1,692) from the DHSC perspective. Costs of monitoring and treating hypophosphatemia after FCM were GBP 226, yielding total savings of GBP 722 per patient (GBP 2,414 versus GBP 1,692) over the five-year time horizon. FDI also led to reduced costs versus FCM in the societal and provider analyses and was therefore the dominant intervention across all three perspectives. LIMITATIONS The analysis did not capture patient adherence, hypophosphatemic osteomalacia, or fractures. CONCLUSIONS Results showed that FDI improved patient QoL and reduced direct healthcare expenditure versus FCM in patients with IBD and IDA in England.
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Affiliation(s)
| | | | - Anjan Dhar
- Department of Gastroenterology, County Durham & Darlington NHS Foundation Trust, Durham, UK
- School of Health and Life Sciences, Teesside University, Teesside, UK
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Koyama AK, Nee R, Yu W, Choudhury D, Heng F, Cheung AK, Norris KC, Cho ME, Yan G. Role of Anemia in Dementia Risk Among Veterans With Incident CKD. Am J Kidney Dis 2023; 82:706-714. [PMID: 37516301 PMCID: PMC10822015 DOI: 10.1053/j.ajkd.2023.04.013] [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: 12/22/2022] [Revised: 03/30/2023] [Accepted: 04/30/2023] [Indexed: 07/31/2023]
Abstract
RATIONALE & OBJECTIVE Although some evidence exists of increased dementia risk from anemia, it is unclear whether this association persists among adults with CKD. Anemia may be a key marker for dementia among adults with CKD, so we evaluated whether anemia is associated with an increased risk of dementia among adults with CKD. STUDY DESIGN Retrospective cohort study. SETTING & PARTICIPANTS The study included 620,095 veterans aged≥45 years with incident stage 3 CKD (estimated glomerular filtration rate [eGFR]<60mL/min/1.73m2) between January 2005 and December 2016 in the US Veterans Health Administration system and followed through December 31, 2018, for incident dementia, kidney failure, or death. EXPOSURE Anemia was assessed based on the average of hemoglobin levels (g/L) during the 2 years before the date of incident CKD and categorized as normal, mild, or moderate/severe anemia (≥12.0, 11.0-11.9,<11.0g/dL, respectively, for women, and≥13.0, 11.0-12.9,<11.0g/dL for men). OUTCOME Dementia and the composite outcome of kidney failure or death. ANALYTICAL APPROACH Adjusted cause-specific hazard ratios were estimated for each outcome. RESULTS At the time of incident CKD, the mean age of the participants was 72 years, 97% were male, and their mean eGFR was 51mL/min per 1.73m2. Over a median 4.1 years of follow-up, 92,306 veterans (15%) developed dementia before kidney failure or death. Compared with the veterans with CKD without anemia, the multivariable-adjusted models showed a 16% (95% CI, 14%-17%) significantly higher risk of dementia for those with mild anemia and a 27% (95% CI, 23%-31%) higher risk with moderate/severe anemia. Combined risk of kidney failure or death was higher at 39% (95% CI, 37%-40%) and 115% (95% CI, 112%-119%) for mild and moderate/severe anemia, respectively, compared with no anemia. LIMITATIONS Residual confounding from the observational study design. Findings may not be generalizable to the broader US population. CONCLUSIONS Anemia was significantly associated with an increased risk of dementia among veterans with incident CKD, underscoring the role of anemia as a predictor of dementia risk. PLAIN-LANGUAGE SUMMARY Adults with chronic kidney disease (CKD) often have anemia. Prior studies among adults in the general population suggest anemia is a risk factor for dementia, though it is unclear whether this association persists among adults with CKD. In this large study of veterans in the United States, we studied the association between anemia and the risk of 2 important outcomes in this population: (1) dementia and (2) kidney failure or death. We found that anemia was associated with a greater risk of dementia as well as risk of kidney failure or death. The study findings therefore emphasize the role of anemia as a key predictor of dementia risk among adults with CKD.
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Affiliation(s)
- Alain K Koyama
- Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Robert Nee
- Walter Reed National Military Medical Center; Uniformed Services University, Bethesda, Maryland
| | - Wei Yu
- University of Virginia, Charlottesville, Virginia
| | - Devasmita Choudhury
- University of Virginia, Charlottesville, Virginia; Virginia-Tech Carilion School of Medicine Medical Center, Roanoke, Virginia; Salem Veterans Affairs Healthcare System, Salem, Virginia
| | - Fei Heng
- University of North Florida, Jacksonville, Florida
| | - Alfred K Cheung
- VA Salt Lake City Healthcare System, Salt Lake City, Utah; University of Utah, Salt Lake City, Utah
| | - Keith C Norris
- University of California-Los Angeles, Los Angeles, California
| | | | - Guofen Yan
- University of Virginia, Charlottesville, Virginia.
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Yusuf MU, Abdurahman N, Asmerom H, Atsbaha T, Alemu A, Weldegebreal F. Prevalence and Associated Factors of Anemia Among Hospital Admitted Patients in Eastern Ethiopia. J Blood Med 2023; 14:575-588. [PMID: 38023805 PMCID: PMC10657767 DOI: 10.2147/jbm.s431047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background Anemia is one of the most common comorbidities frequently seen in admitted patients. However, there is a scarcity of evidence regarding anemia among hospital admitted patients in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the prevalence and associated factors of anemia among hospital admitted patients in Eastern Ethiopia. Methods A hospital-based cross-sectional study was conducted from October 25 to December 30, 2022. Four milliliters of venous blood were collected and complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were entered in Epi-data version 4 and exported to SPSS version 26 for statistical analysis. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of < 0.05. Results Of the 381 hospital admitted patients, 64.8% (95% CI = 60.01, 69.65) of the participants were anemic. Admitted patients who drank standard alcohol daily (AOR = 3.78, 95% CI = 1.71, 8.30), underweight (AOR = 9.39, 95% CI = 2.90, 30.46), and undernourished patients (AOR = 2.59, 95% CI = 1.15, 5.84), patients admitted with chronic kidney disease (AOR = 11.16, 95% CI = 4.06, 30.64), chronic liver disease (AOR = 3.20, 95% CI = 1.21, 8.47), deep vein thrombosis (AOR = 6.22, 95% CI = 1.98, 19.52), infectious disease (AOR = 9.71, 95% CI = 2.77, 34.02), and chronic non-communicable disease (AOR = 7.01, 95% CI = 1.90, 25.99) were all significantly associated with anemia. Conclusion Anemia was common among hospital admitted patients and should prompt the focus on admission diagnoses that are likely to play leading roles in etiology. This information indicates a need for routine screening of anemia for all admitted patients to improve their health.
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Affiliation(s)
- Mohammed Umer Yusuf
- Department of Internal Medicine, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nuredin Abdurahman
- Department of Internal Medicine, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Atsbaha
- Department of Internal Medicine, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Alemu
- Department of Pathology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fitsum Weldegebreal
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Kim Y, Voit A, Weissler EH, Southerland KW, Long CA, Patel SS, Dua A, Mohapatra A. Preoperative Anemia is Associated with Poorer Postoperative Outcomes in Patients Undergoing Infrainguinal Bypass Surgery. Ann Vasc Surg 2023; 97:1-7. [PMID: 36641087 DOI: 10.1016/j.avsg.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/01/2023] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Preoperative anemia is an important, modifiable risk factor among surgical patients. However, data are scarce on the impact of preoperative anemia on postoperative outcomes after infrainguinal bypass. METHODS In this multi-institutional analysis, data were retrospectively collected on all infrainguinal bypass procedures performed between 2010 and 2020. Patients were grouped by preoperative hemoglobin as per the National Cancer Institute anemia scale (mild, 10 g/dL-lower limit of normal; moderate, 8.0-9.9 g/dL; severe, 6.5-7.9 g/dL). Multivariable comparisons were performed using logistic regression analysis. RESULTS A total of 492 patients underwent bypass for peripheral artery disease over the 10-year study period. Median preoperative hemoglobin was 11.0 g/dL (interquartile range 9.5-12.7) and median follow-up was 1.7 years. Preoperative anemia was prevalent among bypass patients (mild 52.4% [n = 258], moderate 26.4% [n = 130], and severe 5.1% [n = 25]). Women were more likely to have moderate (49.2% [women] vs. 50.8% [men]) or severe anemia (52.0% [women] vs. 48.0% [men]) compared with normal hemoglobin (17.7% [women] vs. 82.3% [men]) (P < 0.001). Patients with preoperative anemia were more likely to present with tissue loss (22.8% [normal] vs. 47.7% [moderate] vs. 52.0% [severe], P = 0.01). Bypass target and conduit types were similar between groups. Anemic patients had longer median hospital length of stay compared with nonanemic patients (4 days [normal] vs. 5 days [mild] vs. 6 days [moderate] vs. 7 days [severe], P < 0.001). Postoperative mortality at 30 days was similar across anemia groups (2.5% [normal] vs. 4.6% [moderate] vs. 8.0% [severe], P = 0.23). On multivariable analysis, however, postoperative mortality was independently associated with severe anemia (odds ratio 7.5 [1.2-48.8], P = 0.04) and male gender (odds ratio 7.5 [1.2-26.4], P = 0.03). CONCLUSIONS Preoperative anemia is common among patients undergoing infrainguinal bypass surgery and is an independent risk factor for postoperative mortality. Future investigation is needed to determine whether correction of anemia improves postoperative outcomes in these high-risk patients.
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Affiliation(s)
- Young Kim
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
| | - Antanina Voit
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - E Hope Weissler
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Kevin W Southerland
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Chandler A Long
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Shiv S Patel
- Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Anahita Dua
- Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Abhisekh Mohapatra
- Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA
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10
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Baier E, Kluge IA, Hakroush S, Tampe B. Low hemoglobin levels are associated with Bowman's capsule rupture and peritubular capillaritis in ANCA-associated renal vasculitis: a link of vascular injury to anemia? J Nephrol 2023; 36:2305-2316. [PMID: 37676636 PMCID: PMC10638148 DOI: 10.1007/s40620-023-01748-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/29/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Anemia in anti-neutrophil cytoplasmic antibody (ANCA)-associated renal vasculitis is a severe complication that predicts renal survival. We here conducted correlative analyses to evaluate correlations of low hemoglobin levels and histopathological characteristics in ANCA-associated renal vasculitis. METHODS Fifty-two patients with biopsy-proven ANCA-associated renal vasculitis observed between 2015 and 2020 were retrospectively evaluated. Spearman's correlation was performed to assess correlations, and statistical evaluation was performed by simple and stepwise multivariable regression. RESULTS Regarding laboratory anemia parameters, no significant association with serum hemoglobin levels was observed. Serum hemoglobin levels were associated with the estimated glomerular filtration rate in the total cohort (β = 0.539, p < 0.001), and in the MPO-ANCA subgroup (β = 0.679, p = 0.008). Among tubulointerstitial lesions, decreased serum hemoglobin levels correlated with peritubular capillaritis in the whole cohort (β = - 0.358, p = 0.013), and was suggested in the MPO-ANCA subgroup (p = 0.029, r = - 0.446). Regarding glomerular lesions, the prevalence of necrotic glomeruli significantly associated with low serum hemoglobin levels in PR3-ANCA (β = - 0.424, p = 0.028). In the total cohort, a significant correlation between decreased serum hemoglobin levels and the occurrence of diffuse Bowman's capsule rupture was identified (β = - 0.374, p = 0.014), which was implied in the MPO-ANCA subgroup (p = 0.013, r = - 0.546; p = 0.0288, slope = - 16.65). CONCLUSION Peritubular capillaritis and Bowman's capsule rupture correlate with low hemoglobin levels; this may indicate that histopathological lesions are linked with inflammatory vascular injury and relative erythropoietin deficiency in ANCA-associated renal vasculitis.
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Affiliation(s)
- Eva Baier
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Georg August University, Göttingen, Germany
| | | | - Samy Hakroush
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
- SYNLAB Pathology Hannover, SYNLAB Holding Germany, Augsburg, Germany
| | - Björn Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Georg August University, Göttingen, Germany.
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11
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Martinez-Torres V, Torres N, Davis JA, Corrales-Medina FF. Anemia and Associated Risk Factors in Pediatric Patients. Pediatric Health Med Ther 2023; 14:267-280. [PMID: 37691881 PMCID: PMC10488827 DOI: 10.2147/phmt.s389105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
Anemia is the most common hematologic abnormality identified in children and represents a major global health problem. A delay in diagnosis and treatment might place patients with anemia at risk for the development of rare but serious complications, including chronic and irreversible cognitive impairment. Identified risk factors contributing to the development of anemia in children include the presence of nutritional deficiencies, environmental factors, chronic comorbidities, and congenital disorders of hemoglobin or red blood cells. Pediatricians, especially those in the primary care setting, serve a particularly critical role in the identification and care of those children affected by anemia. Prompt recognition of these risk factors is crucial for developing appropriate and timely therapeutic interventions and prevention strategies.
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Affiliation(s)
- Valerie Martinez-Torres
- Holtz Children’s Hospital – Jackson Memorial Medical Center, Miami, FL, USA
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami – Miller School of Medicine, Miami, FL, USA
| | - Nicole Torres
- Holtz Children’s Hospital – Jackson Memorial Medical Center, Miami, FL, USA
- Division of General Pediatrics, Department of Pediatrics, University of Miami – Miller School of Medicine, Miami, FL, USA
| | - Joanna A Davis
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami – Miller School of Medicine, Miami, FL, USA
- University of Miami – Hemophilia Treatment Center, Miami, FL, USA
| | - Fernando F Corrales-Medina
- Holtz Children’s Hospital – Jackson Memorial Medical Center, Miami, FL, USA
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Miami – Miller School of Medicine, Miami, FL, USA
- University of Miami – Hemophilia Treatment Center, Miami, FL, USA
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12
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Lee DY, Shin S. Sarcopenia and Anemia in Elderly Koreans: A Nationwide Population-Based Study. Healthcare (Basel) 2023; 11:2428. [PMID: 37685462 PMCID: PMC10487604 DOI: 10.3390/healthcare11172428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Sarcopenia and anemia are common diseases in the elderly and are caused by various factors. In this study, the association between sarcopenia and anemia in an elderly Korean population was examined. The Korea Centers for Disease Control and Prevention's cross-sectional, nationally representative Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2011) served as the source of the data for this study. Of the 2769 participants (1167 men and 1602 women) included in this study, a significant association was found between sarcopenia and anemia in the elderly in Korea. In Model 1, unadjusted for covariates, the prevalence of sarcopenia in all participants was 1.805 (95% CI 1.364-2.388) and 2.746 (95% CI 1.740-4.334) in men, and 1.494 (95% CI 1.045-2.138) in women. In Model 4, adjusted for all covariates, the prevalence of sarcopenia in all participants was 1.455 (95% CI 1.064-1.989) and 2.649 (95% CI 1.475-4.755) in men, but it was insignificant in women. While prior studies failed to consider variables such as exercise status and nutritional intake, this research incorporated these factors as covariates. Despite this comprehensive approach, this study still revealed an independent association between sarcopenia and anemia. Moreover, a significant association was uncovered among elderly men, with no corresponding association identified among women.
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Affiliation(s)
- Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
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13
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Wang Y, Ming J, Guo Z, Zhang W, Li X, Zhou S, Li X, Ma H. Association of serum uric acid with anemia in U.S. adults: a cross-sectional study using secondary data. BMC Cardiovasc Disord 2023; 23:291. [PMID: 37291524 PMCID: PMC10251553 DOI: 10.1186/s12872-023-03291-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND High serum uric acid (SUA) is a risk factor of cardiovascular disease (CVD). Abnormal SUA have been correlated with a significant increase in mortality. Anemia is an independent predictor of mortality and CVD. To date, no study has investigated the relationship between SUA and anemia. Here, we explored the correlation between SUA and anemia in the American population. METHODS The cross-sectional study involved 9205 US adults from NHANES (2011-2014). The relationship between SUA and anemia was explored using multivariate linear regression models. Two-piecewise linear regression model, generalized additive models (GAM) and smooth curve fitting were performed to explore the non-linear relationships between SUA and anemia. RESULTS We found a U-shaped non-linear relationship between SUA and anemia. The inflection point of the SUA concentration curve was 6.2 mg/dL. The ORs (95% CIs) for anemia on the left and right of the inflection point were 0.86 (0.78-0.95) and 1.33 (1.16-1.52), respectively. The 95% CI of inflection point was 5.9-6.5 mg/dL. The findings showed that both genders presented a U-shaped correlation. Safe ranges of SUA in men and women were 6-6.5 and 4.3-4.6 mg/dL, respectively. CONCLUSIONS Both high and low SUA levels were correlated with increased risk of anemia, and a U-shaped relationship was observed between SUA and anemia.
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Affiliation(s)
- Yingying Wang
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Jingjing Ming
- Department of Emergency Trauma Surgery, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Zongyun Guo
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Wei Zhang
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Xiang Li
- Department of Nephrology, Affiliated Hospital of Jining Medical University, No.6 Jiankang Road, Jining, 272011, Shandong, China
| | - Shengguo Zhou
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Xia Li
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China.
| | - Huijuan Ma
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China.
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14
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Sappani M, Mani T, Asirvatham ES, Joy M, Babu M, Jeyaseelan L. Trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age during the last 15 years in India. PLoS One 2023; 18:e0286464. [PMID: 37262022 DOI: 10.1371/journal.pone.0286464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Anaemia is a serious global public health problem that disproportionally affects children, adolescent girls, and women of reproductive age, especially pregnant women. Women of reproductive age are more vulnerable to anaemia, particularly severe and moderate anaemia leads to adverse outcomes among pregnant women. Despite continuous Government efforts, anaemia burden still poses a serious challenge in India. The objective of this study is to assess the trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age between 15 and 49 years. METHOD We used three rounds of the large-scale National Family Health Survey (NFHS) India, conducted on a representative sample of households using a cross-sectional design across the country in 2005-06, 2015-16 and 2019-2021. We included all the women aged 15 to 49 years in our analysis. We used the same haemoglobin (Hb) cut-off values for all the three rounds of surveys to ensure comparability. Generalized linear regression analyses with log link were done. Survey weights were incorporated in the analysis. RESULTS The prevalence of severe or moderate Anaemia (SMA) in non-pregnant women was 14.20%, 12.43% and 13.98%; it was 31.11%, 25.98% and 26.66% for pregnant women in 2006, 2016 and 2021 respectively. The decline in SMA prevalence was 1.54% in non-pregnant women, whereas it was 14.30% in pregnant women in 15 years. Women who were poor, and without any formal education had a higher risk for severe and moderate Anaemia. CONCLUSION Despite the intensive anaemia control program in India, SMA has not declined appreciably in non-pregnant women during the last two decades. Despite the decline, the prevalence of SMA was about 26% in pregnant women which calls for a comprehensive review of the existing anaemia control programmes and there must be targeted programmes for the most vulnerable and high-risk women such as rural, poor and illiterate women of reproductive age to reduce the burden of anaemia among them.
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Affiliation(s)
- Marimuthu Sappani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thenmozhi Mani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Melvin Joy
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Malavika Babu
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Lakshmanan Jeyaseelan
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, UAE
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15
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Abalaka SE, Audu Z, Kolawole VO, Adeyemo BT, Idoko IS, Okafor ROS, Oyelowo-Abdulraheem FO, Tags SZ, Ogbe AO, Sanni S, Jegede OC, Sani NA, Tenuche OZ, Tizhe EV, Ejeh SA, Zachariya E. A case of chronic schistosomiasis in a Dongola stallion ( Equus ferus caballus Linnaeus, 1758) from Nigeria. J Parasit Dis 2023; 47:442-450. [PMID: 37193489 PMCID: PMC10182229 DOI: 10.1007/s12639-023-01581-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/30/2023] [Indexed: 05/18/2023] Open
Abstract
Schistosomiasis is a worldwide snail-borne parasitic infestation of man and animals with acute or chronic phases having devastating sequelae. The present case report focused on post-mortem examination of a cachexic Dongola stallion (Equus ferus caballus Linnaeus, 1758) in Abuja, Nigeria, that failed to respond to treatment. Typical dense collagenous granulomatous lesions with marked inflammatory responses and fibrosis occurred in the liver and several visceral organs of the horse along with other lesions indicative of systemic collapse. Special Ziehl-Neelsen and Periodic Acid-Schiff staining as well as microbial culture returned negative results to rule out acid-fast bacilli, fungal, and other bacterial involvement. In addition, the presence of a yellowish-brown eggshell within fibrosing granulomatous lesions led to the diagnosis of chronic schistosomiasis. Prolonged malnutrition under harsh and changing increment weather conditions with lack of medical care following the infection might have predisposed the horse to the recorded systemic collapse in the present case. The dearth of information on the ante-mortem evaluation of acute equine schistosomiasis cases notwithstanding, the observed lesions/cellular changes reinforced associated multi-organ damages and systemic collapse in chronic cases. Our findings highlighted the pathological presentations and prognosis of chronic schistosomiasis and its triggers, especially in endemic areas, and in horses that often do not present obvious clinical manifestations.
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Affiliation(s)
- Samson Eneojo Abalaka
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Zakariya Audu
- Department of Animal Health and Production, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Victor Olumayowa Kolawole
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Bolade Thomas Adeyemo
- Department of Animal Health and Production, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Idoko Sunday Idoko
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | | | | | - Sam Zachariya Tags
- Department of Veterinary Anatomy, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Adamu Okuwa Ogbe
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Saka Sanni
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Olorunfemi Cornelius Jegede
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Nuhu Abdulazeez Sani
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Oremeyi Zaynab Tenuche
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Emmanuel Vandi Tizhe
- Department of Veterinary Microbiology and Pathology, Faculty of Veterinary Medicine, University of Jos, Jos, Nigeria
| | - Sunday Augustine Ejeh
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Esther Zachariya
- Veterinary Teaching Hospital, University of Abuja, Abuja, Nigeria
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16
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Koyama AK, Lundeen E, McKeever Bullard K, Pavkov ME. Prevalence of Anemia and Associated All-Cause Mortality Among Adults With Diabetes: The Role of Chronic Kidney Disease. Diabetes Res Clin Pract 2023; 200:110695. [PMID: 37156427 DOI: 10.1016/j.diabres.2023.110695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023]
Abstract
AIMS Among adults with diabetes in the United States, we evaluated anemia prevalence by CKD status as well as the role of CKD and anemia, as potential risk factors for all-cause mortality. METHODS In a retrospective cohort study, we included 6,718 adult participants with prevalent diabetes from the 2003-March 2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the non-institutionalized civilian population in the United States. Cox regression models evaluated the role of anemia and CKD, alone or combined, as predictors of all-cause mortality. RESULTS Anemia prevalence among adults with diabetes and CKD was 20%. Having anemia or CKD alone, compared with having neither condition, was significantly associated with all-cause mortality (anemia: HR=2.10 [1.49-2.96], CKD: HR=2.24 [1.90-2.64]). Having both conditions conferred a greater potential risk (HR=3.41 [2.75-4.23]). CONCLUSIONS Approximately one-quarter of the adult US population with diabetes and CKD also has anemia. The presence of anemia, with or without CKD, is associated with a two- to threefold increased risk of death by compared with adults who have neither condition, suggesting that anemia may be a strong predictor of death among adults with diabetes.
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Affiliation(s)
- Alain K Koyama
- Centers for Disease Control and Prevention, Division of Diabetes Translation, 4770 Buford Hwy, NE, MS-S107-3, Atlanta, GA 30341-3724.
| | - Elizabeth Lundeen
- Centers for Disease Control and Prevention, Division of Diabetes Translation, 4770 Buford Hwy, NE, MS-S107-3, Atlanta, GA 30341-3724.
| | - Kai McKeever Bullard
- Centers for Disease Control and Prevention, Division of Diabetes Translation, 4770 Buford Hwy, NE, MS-S107-3, Atlanta, GA 30341-3724.
| | - Meda E Pavkov
- Centers for Disease Control and Prevention, Division of Diabetes Translation, 4770 Buford Hwy, NE, MS-S107-3, Atlanta, GA 30341-3724
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17
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Josselsohn R, Barnes BJ, Kalfa TA, Blanc L. Navigating the marrow sea towards erythromyeloblastic islands under normal and inflammatory conditions. Curr Opin Hematol 2023; 30:80-85. [PMID: 36718814 PMCID: PMC10065913 DOI: 10.1097/moh.0000000000000756] [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] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Terminal erythroid differentiation occurs in specialized niches called erythroblastic islands. Since their discovery in 1958, these niches have been described as a central macrophage surrounded by differentiating erythroblasts. Here, we review the recent advances made in the characterization of these islands and the role they could play in anaemia of inflammation. RECENT FINDINGS The utilization of multispectral imaging flow cytometry (flow cytometry with microscopy) has enabled for a more precise characterization of the niche that revealed the presence of maturing granulocytes in close contact with the central macrophage. These erythromyeloblastic islands (EMBIs) can adapt depending on the peripheral needs. Indeed, during inflammation wherein inflammatory cytokines limit erythropoiesis and promote granulopoiesis, EMBIs present altered structures with increased maturing granulocytes and decreased erythroid precursors. SUMMARY Regulation of the structure and function of the EMBI in the bone marrow emerges as a potential player in the pathophysiology of acute and chronic inflammation and its associated anaemia.
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Affiliation(s)
- Rachel Josselsohn
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY 11030
- Zucker School of Medicine at Hofstra Northwell, Hempstead NY 11549
| | - Betsy J. Barnes
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY 11030
- Zucker School of Medicine at Hofstra Northwell, Hempstead NY 11549
- Division of Pediatrics Hematology/Oncology, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | | | - Lionel Blanc
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY 11030
- Zucker School of Medicine at Hofstra Northwell, Hempstead NY 11549
- Division of Pediatrics Hematology/Oncology, Cohen Children’s Medical Center, New Hyde Park, NY 11040
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18
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Chen OCW, Siebel S, Colaco A, Nicoli ER, Platt N, Shepherd D, Newman S, Armitage AE, Farhat NY, Seligmann G, Smith C, Smith DA, Abdul-Sada A, Jeyakumar M, Drakesmith H, Porter FD, Platt FM. Defective iron homeostasis and hematological abnormalities in Niemann-Pick disease type C1. Wellcome Open Res 2023; 7:267. [PMID: 37065726 PMCID: PMC10090865 DOI: 10.12688/wellcomeopenres.17261.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Niemann-Pick disease type C1 (NPC1) is a neurodegenerative lysosomal storage disorder characterized by the accumulation of multiple lipids in the late endosome/lysosomal system and reduced acidic store calcium. The lysosomal system regulates key aspects of iron homeostasis, which prompted us to investigate whether there are hematological abnormalities and iron metabolism defects in NPC1. Methods: Iron-related hematological parameters, systemic and tissue metal ion and relevant hormonal and proteins levels, expression of specific pro-inflammatory mediators and erythrophagocytosis were evaluated in an authentic mouse model and in a large cohort of NPC patients. Results: Significant changes in mean corpuscular volume and corpuscular hemoglobin were detected in Npc1 -/- mice from an early age. Hematocrit, red cell distribution width and hemoglobin changes were observed in late-stage disease animals. Systemic iron deficiency, increased circulating hepcidin, decreased ferritin and abnormal pro-inflammatory cytokine levels were also found. Furthermore, there is evidence of defective erythrophagocytosis in Npc1 -/- mice and in an in vitro NPC1 cellular model. Comparable hematological changes, including low normal serum iron and transferrin saturation and low cerebrospinal fluid ferritin were confirmed in NPC1 patients. Conclusions: These data suggest loss of iron homeostasis and hematological abnormalities in NPC1 may contribute to the pathophysiology of this disease.
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Affiliation(s)
- Oscar C W Chen
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Stephan Siebel
- Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Alexandria Colaco
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Elena-Raluca Nicoli
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Nick Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Dawn Shepherd
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Stephanie Newman
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Andrew E Armitage
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, Oxfordshire, OX3 9DS, UK
| | - Nicole Y Farhat
- Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - George Seligmann
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Claire Smith
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - David A Smith
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Alaa Abdul-Sada
- Chemistry Department, School of Life Sciences, University of Sussex, Brighton, Sussex, BN1 9QJ, UK
| | - Mylvaganam Jeyakumar
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Hal Drakesmith
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, Oxfordshire, OX3 9DS, UK
| | - Forbes D Porter
- Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Frances M Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
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Farag CM, Antar R, Akosman S, Ng M, Whalen MJ. What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP's prognostic ability in different cancer types. Oncotarget 2023; 14:153-172. [PMID: 36848404 PMCID: PMC9970084 DOI: 10.18632/oncotarget.28367] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
Since its inception, the Hemoglobin, Albumin, Lymphocyte, Platelet Score (HALP) has gained attention as a new prognostic biomarker to predict several clinical outcomes in a multitude of cancers. In our review, we searched PubMed for articles between the first paper on HALP in 2015 through September 2022, yielding 32 studies in total that evaluated HALP's association with various cancers, including Gastric, Colorectal, Bladder, Prostate, Kidney, Esophageal, Pharyngeal, Lung, Breast, and Cervical cancers, among others. This review highlights the collective association HALP has with demographic factors such as age and sex in addition to TNM staging, grade, and tumor size. Furthermore, this review summarizes HALP's prognostic ability to predict overall survival, progression-free survival, recurrence-free survival, among other outcomes. In some studies, HALP has also been able to predict response to immunotherapy and chemotherapy. This review article also aims to serve as a comprehensive and encyclopedic report on the literature that has evaluated HALP as a biomarker in various cancers, highlighting the heterogeneity surrounding HALP's utilization. Because HALP requires only a complete blood count and albumin - already routinely collected for cancer patients - HALP shows potential as a cost-effective biomarker to aid clinicians in improving outcomes for immuno-nutritionally deficient patients.
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Affiliation(s)
- Christian Mark Farag
- Department of Urology, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Ryan Antar
- Department of Urology, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Sinan Akosman
- Department of Urology, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Matthew Ng
- Department of Surgery, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Michael J Whalen
- Department of Urology, George Washington University School of Medicine, Washington, DC 20052, USA
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20
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Seo HY, Mun CY, Park CY, Bin Choi S, Hwang JH, Lee JH, Yoon H. The relationship between hyperuricemia and anemia and metabolic syndrome in Korean adults: The Korea National Health and Nutrition Examination Survey 2019. Prim Care Diabetes 2023; 17:91-97. [PMID: 36456398 DOI: 10.1016/j.pcd.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
AIM The present study was conducted to assess the relationship between hyperuricemia and anemia in Korean adults with or without metabolic syndrome (MetS). METHODS Data from 6073 adults (age ≥ 20 years) in the Eighth Korean National Health and Nutrition Examination Survey (2019) were analyzed. RESULTS Several key findings were identified. First, after adjusting for the related variables, the hemoglobin [Hb] level in the hyperuricemia subgroup (uric acid [UA] ≥ 7.0 mg/dL in men or ≥ 6.0 mg/dL in women) was higher than in the normouricemia subgroup (UA < 7.0 mg/dL in men or < 6.0 mg/dL in women) in subjects with non-MetS (p = 0.005), whereas it was lower than in the normouricemia subgroup in subjects with MetS (p = 0.032). Second, after adjusting for the related variables, the odds ratio (OR) of anemia (Hb < 13.0 g/dL in men or < 12 g/dL in women), using the normouricemia subgroup as a reference, was negatively significant for the hyperuricemia subgroup in subjects with non-MetS (OR, 0.478; 95 % CI, 0.300-0.761) but positively significant for the hyperuricemia subgroup in subjects with MetS (OR, 1.765; 95 % CI, 1.160-2.198). CONCLUSIONS Hyperuricemia was associated with a decrease in anemia in non-MetS but an increase in anemia in MetS.
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Affiliation(s)
- Ha Young Seo
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea
| | - Chae Young Mun
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea
| | - Chea Yeon Park
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea
| | - Soo Bin Choi
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea
| | - Ji Hye Hwang
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea
| | - Jun Ho Lee
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea
| | - Hyun Yoon
- Department of Biomedical Laboratory Science, Wonkwang Health Science University, 345-13, Sinyong-dong, Iksan-si, Jeollabuk-do 54538, South Korea.
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21
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Alborzi A, Hosseini M, Bahrami S, Ghorbanpoor M, Tabandeh M. Evaluation of hematological changes, oxidant/antioxidant status and immuno-logical responses in sheep and goats naturally infected with Linguatula serrata. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2023; 14:161-167. [PMID: 37033775 PMCID: PMC10073812 DOI: 10.30466/vrf.2021.533589.3211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/26/2021] [Indexed: 04/11/2023]
Abstract
Linguatula serrata is a worldwide zoonotic food-borne parasite. The parasite is responsible for linguatulosis and poses a concern to human and animal health in endemic regions. This study investigated the hematological changes, oxidant/antioxidant status and immunological responses in goats and sheep naturally infected with L. serrata. Hematological changes, antioxidant enzymes and malondialdehyde (MDA) levels were measured. The level of inter-leukin-2 (IL-2), IL-4, IL-5, IL-10, and tumor necrosis factor alpha (TNF-α) mRNA expression was investigated in lymph nodes. According to the hemogram results, eosinophils were significantly increased in the infected goats and sheep, and Horizontal Gene Transfer (HGT), hematocrit (HCT), and mean corpuscular hemoglobin concentration (MCHC) were significantly decreased. The levels of MDA and the activity of glutathione peroxidase (GPx) were significantly higher in infected animals than in non-infected animals. However, the activity of superoxide dismutase (SOD) and catalase (CAT) was significantly lower in infected animals than in non-infected animals. A comparison of the cytokine mRNA expression in lymph nodes from infected and non-infected animals showed higher cytokine expression in the infected animals. Infection with L. serrata caused microcytic hypochromic and normocytic hypochromic anemia in goats and sheep. The inconsistent results of immunological changes were found in infected goats and sheep. In both animals, oxidative stress occurred and led to an increase in lipid peroxidation. L. serrata created a cytokine microenvironment biased towards the type 2 immune responses.
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Affiliation(s)
- Alireza Alborzi
- Department of Parasitology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran;
- Correspondence: Alireza Alborzi. PhD , Department of Parasitology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran. E-mail:
| | - Mandana Hosseini
- Department of Parasitology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran;
| | - Somayeh Bahrami
- Department of Parasitology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran;
| | - Masoud Ghorbanpoor
- Department of Immunology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran;
| | - Mohammadreza Tabandeh
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
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22
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Yu D, Chen P, Zhang X, Wang H, Dhuromsingh M, Wu J, Qin B, Guo S, Zhang B, Li C, Zeng H. Association of lymphopenia and RDW elevation with risk of mortality in acute aortic dissection. PLoS One 2023; 18:e0283008. [PMID: 36920980 PMCID: PMC10016706 DOI: 10.1371/journal.pone.0283008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE The study aimed to investigate whether lymphopenia and red blood cell distribution width (RDW) elevation are associated with an increased risk of mortality in acute aortic dissection (AAD). METHODS This multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographic angiography (CTA) from 2010 to 2021 in five teaching hospitals in central-western China. Cox proportional hazards regression and Kaplan-Meier curves were used in univariable and multivariable models. Clinical outcomes were defined as all-cause in-hospital mortality, while associations were evaluated between lymphopenia, accompanied by an elevated RDW, and risk of mortality. RESULTS Of 1903 participants, the median age was 53 (interquartile range [IQR], 46-62) years, and females accounted for 21.9%. Adjusted increased risk of mortality was linearly related to the decreasing lymphocyte percentage (P-non-linearity = 0.942) and increasing RDW (P-non-linearity = 0.612), and per standard deviation (SD) of increment lymphocyte percentage and RDW was associated with the 26% (0.74, 0.64-0.84) decrement and 5% (1.05, 0.95-1.15) increment in hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality, respectively. Importantly, lymphopenia and elevation of RDW exhibited a significant interaction with increasing the risk of AAD mortality (P-value for interaction = 0.037). CONCLUSIONS Lymphopenia accompanied by the elevation of RDW, which may reflect the immune dysregulation of AAD patients, is associated with an increased risk of mortality. Assessment of immunological biomarkers derived from routine tests may provide novel perspectives for identifying the risk of mortality.
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Affiliation(s)
- Dan Yu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, China
- Department of Cardiac Intensive Care Unit, People’s Hospital of Zhengzhou University (Henan Provincial People’s Hospital), Zhengzhou, China
| | - Peng Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xueyan Zhang
- Department of Critical Care Medicine, Henan Key Laboratory for Critical Care Medicine, People’s Hospital of Zhengzhou University (Henan Provincial People’s Hospital), Zhengzhou, China
| | - Hongjie Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, China
| | - Menaka Dhuromsingh
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, China
| | - Jinxiu Wu
- Department of Critical Care Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Bingyu Qin
- Department of Critical Care Medicine, Henan Key Laboratory for Critical Care Medicine, People’s Hospital of Zhengzhou University (Henan Provincial People’s Hospital), Zhengzhou, China
- * E-mail: (BQ); (SG); (BZ); (CL); (HZ)
| | - Suping Guo
- Department of Cardiac Intensive Care Unit, People’s Hospital of Zhengzhou University (Henan Provincial People’s Hospital), Zhengzhou, China
- Department of Cardiac Intensive Care Unit, Central China Fuwai Hospital of Zhengzhou University (Fuwai Central China Cardiovascular Hospital), Zhengzhou, China
- * E-mail: (BQ); (SG); (BZ); (CL); (HZ)
| | - Baoquan Zhang
- Department of Critical Care Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- * E-mail: (BQ); (SG); (BZ); (CL); (HZ)
| | - Chunwen Li
- Department of Emergency Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- * E-mail: (BQ); (SG); (BZ); (CL); (HZ)
| | - Hesong Zeng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, China
- * E-mail: (BQ); (SG); (BZ); (CL); (HZ)
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Zhang W, Wang J, Liu Z, Zhang L, Jing J, Han L, Gao A. Iron-dependent ferroptosis participated in benzene-induced anemia of inflammation through IRP1-DHODH-ALOX12 axis. Free Radic Biol Med 2022; 193:122-133. [PMID: 36244588 DOI: 10.1016/j.freeradbiomed.2022.10.273] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
Benzene, a widely existing environmental pollutant, gives huge harm to the hematopoietic system. Iron is one of the raw materials for the creation of blood cells, but the role of iron in the blood toxicity of benzene is still unknown. Here, we examined the role of iron homeostasis in benzene-induced toxicity both in vivo and in vitro. In this study, mice exposed to benzene at 50 ppm for 8 weeks demonstrated the anemia of inflammation, mainly manifested as the decreased serum Fe2+, increased serum ferritin and inflammation factors (TNF-α, IL6, IL1β) in the plasma of mice. Furthermore, we found that iron maldistribution in the spleen and bone marrow is accompanied by inflammation reaction and ferroptosis. In the vitro study, benzene metabolite 1,4-BQ stimulated the obvious ROS production and ferroptosis activation in the normal B lymphocytes cells. Meanwhile, from the molecular perspective, the combined proteomics and transcriptome enriched the ferroptosis pathway, and we further confirmed the increased expression of iron regulator IRP1, ferroptosis-regulator DHODH, and fatty acids metabolism enzyme ALOX12 were the crucial participators in regulating benzene-mediated iron metabolism imbalance and ferroptosis. Particularly, the targeted and un-targeted metabolomics in the vivo and vitro study further emphasized the importance of DHODH in benzene-induced ferroptosis. In conclusion, this study revealed that iron-dependent ferroptosis participated in benzene-induced anemia of inflammation and provided a constructive perspective on targeting ferroptosis for the prevention and control of benzene toxicity.
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Affiliation(s)
- Wei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Jingyu Wang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - ZiYan Liu
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Lei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Jiaru Jing
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Lin Han
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Ai Gao
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
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24
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Lin CT, Su PJ, Huang SY, Wu CC, Wang HJ, Cheng YT, Luo HL, Chen CH, Liu TT, Huang CC, Su YL. First-line Immune Checkpoint Inhibitor Versus Immune Checkpoint Inhibitor With Chemotherapy for Cisplatin-ineligible Metastatic Urothelial Carcinoma: Evidence From a Real-world, Multicenter Analysis. J Immunother 2022; 45:407-414. [PMID: 36121316 PMCID: PMC9528941 DOI: 10.1097/cji.0000000000000441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022]
Abstract
Immune checkpoint inhibitors (ICIs) are widely used for first-line cisplatin-ineligible patients with metastatic urothelial carcinoma (mUC). However, whether to use ICIs as monotherapy or in combination with chemotherapy is still uncertain. We retrospectively analyzed cisplatin-ineligible patients with mUC who underwent first-line ICI monotherapy or ICI plus chemotherapy at 2 medical centers in Taiwan from 2016 to 2021. We calculated the objective response rate, progression-free survival, and overall survival (OS) using the Kaplan-Meier method and Cox regression model for multivariable analysis. In total, 130 patients were enrolled and categorized into 2 groups: an ICI monotherapy group [immunotherapy (IO), n=101] and an ICI plus noncisplatin chemotherapy group [immunotherapy and chemotherapy (IC), n=29]. The median OS of patients in the IO and IC groups was 19.5 and 9.7 months ( P =0.33). Among patients with high programmed cell death ligand-1-expressing tumors, the median OS was significantly prolonged in the IO group compared with the IC group (not reached vs. 6.3 mo, P =0.02). First-line ICI monotherapy demonstrated robust antitumor activity in cisplatin-ineligible patients with mUC. Combining noncisplatin chemotherapy with ICI did not improve clinical outcomes.
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Affiliation(s)
- Chang-Ting Lin
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
| | - Po-Jung Su
- Division of Hematology Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, College of Medicine, Taoyuan
| | - Shih-Yu Huang
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
| | - Chia-Che Wu
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
| | | | | | | | | | | | - Chun-Chieh Huang
- Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine
| | - Yu-Li Su
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung
- Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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25
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Kim H, Han K, Ko SH, An HJ. Association between serum ferritin levels and colorectal cancer risk in Korea. Korean J Intern Med 2022; 37:1205-1215. [PMID: 36278251 PMCID: PMC9666249 DOI: 10.3904/kjim.2022.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS The concentration of serum ferritin, a storage form of iron, may be associated with carcinogenesis in various cancers. There are only limited studies on the relationship between serum ferritin levels and colorectal cancer (CRC) risk, especially in the Asian population. This study aimed to analyze the association between CRC incidence and serum ferritin levels. METHODS This was a national cohort study that used health checkup and insurance claims data of the Korean population. CRC incidence according to the serum ferritin level was analyzed during 2008-2018 in 17,116 participants. RESULTS The hazard ratio (HR) of CRC incidence decreased as serum ferritin levels increased (Q1: HR, 1.000 [95% confidence interval [CI], reference]; Q2: HR, 0.811 [95% CI, 0.558 to 1.178]; Q3: HR, 0.654 [95% CI, 0.442 to 0.968]; Q4: HR, 0.443 [95% CI, 0.285 to 0.687]; p = 0.0026). In subgroup analysis, 40 to 64 years of age, sex, body mass index of < 25 kg/ m2, presence of metabolic syndrome, absence of diabetes mellitus, and absence of anemia had HRs of < 0.5 (95% CI) in the highest quartiles compared with that in the lowest quartiles. CONCLUSION This study shows an inverse association between serum ferritin and CRC risk. Serum ferritin measurement can aid in identifying young adults requiring active CRC screening.
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Affiliation(s)
- Hyunho Kim
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon,
Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul,
Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon,
Korea
| | - Ho Jung An
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon,
Korea
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26
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Chen OCW, Siebel S, Colaco A, Nicoli ER, Platt N, Shepherd D, Newman S, Armitage AE, Farhat NY, Seligmann G, Smith C, Smith DA, Abdul-Sada A, Jeyakumar M, Drakesmith H, Porter FD, Platt FM. Defective iron homeostasis and hematological abnormalities in Niemann-Pick disease type C1. Wellcome Open Res 2022; 7:267. [PMID: 37065726 PMCID: PMC10090865 DOI: 10.12688/wellcomeopenres.17261.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Niemann-Pick disease type C1 (NPC1) is a neurodegenerative lysosomal storage disorder characterized by the accumulation of multiple lipids in the late endosome/lysosomal system and reduced acidic store calcium. The lysosomal system regulates key aspects of iron homeostasis, which prompted us to investigate whether there are hematological abnormalities and iron metabolism defects in NPC1. Methods: Iron-related hematological parameters, systemic and tissue metal ion and relevant hormonal and proteins levels, expression of specific pro-inflammatory mediators and erythrophagocytosis were evaluated in an authentic mouse model and in a large cohort of NPC patients. Results: Significant changes in mean corpuscular volume and corpuscular hemoglobin were detected in Npc1 -/- mice from an early age. Hematocrit, red cell distribution width and hemoglobin changes were observed in late-stage disease animals. Systemic iron deficiency, increased circulating hepcidin, decreased ferritin and abnormal pro-inflammatory cytokine levels were also found. Furthermore, there is evidence of defective erythrophagocytosis in Npc1 -/- mice and in an in vitro NPC1 cellular model. Comparable hematological changes, including low normal serum iron and transferrin saturation and low cerebrospinal fluid ferritin were confirmed in NPC1 patients. Conclusions: These data suggest loss of iron homeostasis and hematological abnormalities in NPC1 may contribute to the pathophysiology of this disease.
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Affiliation(s)
- Oscar C W Chen
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Stephan Siebel
- Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Alexandria Colaco
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Elena-Raluca Nicoli
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Nick Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Dawn Shepherd
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Stephanie Newman
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Andrew E Armitage
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, Oxfordshire, OX3 9DS, UK
| | - Nicole Y Farhat
- Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - George Seligmann
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Claire Smith
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - David A Smith
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Alaa Abdul-Sada
- Chemistry Department, School of Life Sciences, University of Sussex, Brighton, Sussex, BN1 9QJ, UK
| | - Mylvaganam Jeyakumar
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
| | - Hal Drakesmith
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, Oxfordshire, OX3 9DS, UK
| | - Forbes D Porter
- Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Frances M Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, Oxfordshire, OX1 3QT, UK
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27
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Mustafa Ali MK, Naser AY, AbuAlhommos A, Al-Daghastani T, Alrawashdeh H, Mustafa Ali S, Alwafi H, Alqurashi MM, Basha Ahmed AH, Albarqi H. Hospital Admissions Secondary to Diseases of the Blood, Blood-Forming Organs, and Immune System in England and Wales. Cureus 2022; 14:e30179. [DOI: 10.7759/cureus.30179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
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28
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Chandra J, Dewan P, Kumar P, Mahajan A, Singh P, Dhingra B, Radhakrishnan N, Sharma R, Manglani M, Rawat AK, Gupta P, Gomber S, Bhat S, Gaikwad P, Elizabeth KE, Bansal D, Dubey AP, Shah N, Kini P, Trehan A, Datta K, Basavraja GV, Saxena V, Kumar RR. Diagnosis, Treatment and Prevention of Nutritional Anemia in Children: Recommendations of the Joint Committee of Pediatric Hematology-Oncology Chapter and Pediatric and Adolescent Nutrition Society of the Indian Academy of Pediatrics. Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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29
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NCOA4 Regulates Iron Recycling and Responds to Hepcidin Activity and Lipopolysaccharide in Macrophages. Antioxidants (Basel) 2022; 11:antiox11101926. [PMID: 36290647 PMCID: PMC9598790 DOI: 10.3390/antiox11101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/18/2022] [Accepted: 09/23/2022] [Indexed: 01/18/2023] Open
Abstract
Macrophages, via erythrophagocytosis, recycle iron from effete erythrocytes to newly developing red blood cells. Conversion of potentially cytotoxic levels of iron from its heme into nonheme form during iron recycling is safely accomplished via coordinated regulations of cellular iron transport and homeostasis. Herein, we demonstrate the roles and regulation of NCOA4 (nuclear receptor coactivator 4)-mediated ferritinophagy in macrophages after erythrophagocytosis using the mouse macrophage cell line J774 cells. Ferritin in J774 cells increased with the rise of nonheme iron by erythrocyte ingestion and declined when total cellular iron contents subsequently decreased. NCOA4, a selective autophagic cargo receptor for ferritin, was responsible for the control of cellular ferritin and total iron contents at the later stage of erythrophagocytosis. A hepcidin analog, which limits the flux of iron through iron-recycling by inhibiting iron export at the plasma membrane, repressed NCOA4 expression and led to accumulation of ferritin in the mouse macrophages. Transcriptome analyses revealed a functional association of immune response with NCOA4-dependent gene expressions, and we confirmed repression of Ncoa4 by lipopolysaccharide (LPS) in J774 cells and the spleen of mice. Collectively, our studies indicate that NCOA4 facilitates cellular ferritin turnover and the release of iron by macrophages after erythrophagocytosis and functions as a regulatory target for molecular signals of systemic iron overload and inflammation. These identify macrophage NCOA4 as a potential therapeutic target for disorders of systemic iron dysregulation, including anemia of inflammation and hemochromatosis.
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30
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Patel H, Modi N, Chaudhari J, Patel P, Giri P, Patel H, Pandya V, Desai R, Jain M. Nonclinical Pharmacokinetic Evaluation of Desidustat: a Novel Prolyl Hydroxylase Inhibitor for the Treatment of Anemia. Eur J Drug Metab Pharmacokinet 2022; 47:725-740. [PMID: 35881329 DOI: 10.1007/s13318-022-00788-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Desidustat is a novel prolyl hydroxylase domain (PHD) inhibitor for the treatment of anemia. The objective of this study was to investigate the pharmacokinetics and drug-drug interaction properties of desidustat using in vitro and in vivo nonclinical models. METHODS In vitro, Caco2 cell permeability, plasma protein binding, metabolism, cytochrome P450 (CYP) inhibition, and CYP induction were examined. In vivo, pharmacokinetic studies of oral bioavailability in mice, rats, dogs and monkeys, dose linearity, tissue distribution, and excretion in rats were conducted. RESULTS In Caco-2 cells, the apparent permeability of desidustat was high at low pH and low at neutral pH. The oral bioavailability (%F) of desidustat was 43-100% with a median time to reach peak concentration (Tmax) of about 0.25-1.3 h across species. Desidustat displayed a low mean plasma clearance (CL) of 1.3-4.1 mL/min/kg (approximately 1.8-7.4% of hepatic blood flow), and the mean steady-state volume of distribution (Vss) was 0.2-0.4 L/kg (approximately 30-61% of the total body water). Desidustat showed a dose-dependent increase in exposures over the 15-100 mg/kg dose range. It was rapidly distributed in various tissues, with the highest tissue-to-blood ratio in the liver (1.8) and kidney (1.7). Desidustat showed high plasma protein binding and was metabolically stable in human liver microsomes, hepatocytes, and recombinant CYPs. It did not show significant inhibition of major drug-metabolizing CYP enzymes (IC50 > 300 µM) or the potential to induce CYP1A2 and CYP3A4/5 (up to 100 µM) in HepG2 cells. It may have minimal potential of clinical drug-drug interaction when used in combination with iron supplements or phosphate binders. Desidustat was primarily excreted unchanged in urine (25% of the oral dose) and bile (25% of the oral dose) in rats. The mean elimination half-life of desidustat ranged from 1.0 to 5.3 h and 1.3 to 5.7 h across species after intravenous and oral administration, respectively. CONCLUSION Taken together, desidustat is well absorbed orally. It showed a dose-dependent increase in exposure, did not accumulate in tissue, and was eliminated via dual routes. It is metabolically stable, has minimal potential to cause clinical drug-drug interactions (DDIs), and demonstrates discriminable pharmacokinetic properties for the treatment of anemia.
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Affiliation(s)
- Harilal Patel
- Department of Drug Metabolism and Pharmacokinetics, Zydus Research Centre, Zydus Lifesciences Limited, Sarkhej-Bavla N.H. No. 8A, Moraiya. Tal: Sanand, Ahmedabad, Gujarat, 382213, India.
| | - Nirav Modi
- Department of Drug Metabolism and Pharmacokinetics, Zydus Research Centre, Zydus Lifesciences Limited, Sarkhej-Bavla N.H. No. 8A, Moraiya. Tal: Sanand, Ahmedabad, Gujarat, 382213, India
| | - Jaimin Chaudhari
- Department of Drug Metabolism and Pharmacokinetics, Zydus Research Centre, Zydus Lifesciences Limited, Sarkhej-Bavla N.H. No. 8A, Moraiya. Tal: Sanand, Ahmedabad, Gujarat, 382213, India
| | - Prakash Patel
- Department of Drug Metabolism and Pharmacokinetics, Zydus Research Centre, Zydus Lifesciences Limited, Sarkhej-Bavla N.H. No. 8A, Moraiya. Tal: Sanand, Ahmedabad, Gujarat, 382213, India
| | - Poonam Giri
- Department of Drug Metabolism and Pharmacokinetics, Zydus Research Centre, Zydus Lifesciences Limited, Sarkhej-Bavla N.H. No. 8A, Moraiya. Tal: Sanand, Ahmedabad, Gujarat, 382213, India
| | - Hiren Patel
- Department of Molecular Pharmacology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, Gujarat, 382213, India
| | - Vrajesh Pandya
- Department of Medicinal Chemistry, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, Gujarat, 382213, India
| | - Ranjit Desai
- Department of Medicinal Chemistry, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, Gujarat, 382213, India
| | - Mukul Jain
- Department of Drug Metabolism and Pharmacokinetics, Zydus Research Centre, Zydus Lifesciences Limited, Sarkhej-Bavla N.H. No. 8A, Moraiya. Tal: Sanand, Ahmedabad, Gujarat, 382213, India.,Department of Molecular Pharmacology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, Gujarat, 382213, India
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Han X, Ji P. Carbon dots for the treatment of cancer-related anemia. BLOOD SCIENCE 2022; 4:174-175. [PMID: 36518596 PMCID: PMC9742109 DOI: 10.1097/bs9.0000000000000120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Xu Han
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Peng Ji
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
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Valentine T, Hardowar L, Elphick-Ross J, Hulse RP, Paul-Clark M. The Role of Vascular-Immune Interactions in Modulating Chemotherapy Induced Neuropathic Pain. Front Pharmacol 2022; 13:887608. [PMID: 35814225 PMCID: PMC9257211 DOI: 10.3389/fphar.2022.887608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/23/2022] [Indexed: 12/05/2022] Open
Abstract
Chemotherapy causes sensory disturbances in cancer patients that results in neuropathies and pain. As cancer survivorships has dramatically increased over the past 10 years, pain management of these patients is becoming clinically more important. Current analgesic strategies are mainly ineffective and long-term use is associated with severe side effects. The issue being that common analgesic strategies are based on ubiquitous pain mediator pathways, so when applied to clinically diverse neuropathic pain and neurological conditions, are unsuccessful. This is principally due to the lack of understanding of the driving forces that lead to chemotherapy induced neuropathies. It is well documented that chemotherapy causes sensory neurodegeneration through axonal atrophy and intraepidermal fibre degeneration causing alterations in pain perception. Despite the neuropathological alterations associated with chemotherapy-induced neuropathic pain being extensively researched, underlying causes remain elusive. Resent evidence from patient and rodent studies have indicated a prominent inflammatory cell component in the peripheral sensory nervous system in effected areas post chemotherapeutic treatment. This is accompanied by modulation of auxiliary cells of the dorsal root ganglia sensory neurons such as activation of satellite glia and capillary dysfunction. The presence of a neuroinflammatory component was supported by transcriptomic analysis of dorsal root ganglia taken from mice treated with common chemotherapy agents. With key inflammatory mediators identified, having potent immunoregulatory effects that directly influences nociception. We aim to evaluate the current understanding of these immune-neuronal interactions across different cancer therapy drug classes. In the belief this may lead to better pain management approaches for cancer survivors.
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Single Nucleotide Polymorphisms in XMN1-HBG2, HBS1L-MYB, and BCL11A and Their Relation to High Fetal Hemoglobin Levels That Alleviate Anemia. Diagnostics (Basel) 2022; 12:diagnostics12061374. [PMID: 35741184 PMCID: PMC9221560 DOI: 10.3390/diagnostics12061374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023] Open
Abstract
Anemia is a condition in which red blood cells and/or hemoglobin (Hb) concentrations are decreased below the normal range, resulting in a lack of oxygen being transported to tissues and organs. Those afflicted with this condition may feel lethargic and weak, which reduces their quality of life. The condition may be manifested in inherited blood disorders, such as thalassemia and sickle cell disease, whereas acquired disorders include aplastic anemia, chronic disease, drug toxicity, pregnancy, and nutritional deficiency. The augmentation of fetal hemoglobin (HbF) results in the reduction in clinical symptoms in beta-hemoglobinopathies. Several transcription factors as well as medications such as hydroxyurea may help red blood cells produce more HbF. HbF expression increases with the downregulation of three main quantitative trait loci, namely, the XMN1-HBG2, HBS1L-MYB, and BCL11A genes. These genes contain single nucleotide polymorphisms (SNPs) that modulate the expression of HbF differently in various populations. Allele discrimination is important in SNP genotyping and is widely applied in many assays. In conclusion, the expression of HbF with a genetic modifier is crucial in determining the severity of anemic diseases, and genetic modification of HbF expression may offer clinical benefits in diagnosis and disease management.
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Nattagh-Eshtivani E, Gheflati A, Barghchi H, Rahbarinejad P, Hachem K, Shalaby MN, Abdelbasset WK, Ranjbar G, Olegovich Bokov D, Rahimi P, Gholizadeh Navashenaq J, Pahlavani N. The role of Pycnogenol in the control of inflammation and oxidative stress in chronic diseases: Molecular aspects. Phytother Res 2022; 36:2352-2374. [PMID: 35583807 DOI: 10.1002/ptr.7454] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/23/2022] [Accepted: 03/15/2022] [Indexed: 02/05/2023]
Abstract
The prevalence of chronic diseases has increased significantly with the rising trend of sedentary lifestyles, reduced physical activity, and dietary modifications in recent decades. Inflammation and oxidative stress play a key role in the pathophysiology of several chronic diseases, such as type II diabetes, cardiovascular diseases, and hepatic conditions. Therefore, reducing inflammation and oxidative stress may be beneficial in the prevention and treatment of various chronic disorders. Since chronic diseases are not completely curable, various methods have been proposed for their control. Complementary therapies and the use of natural antioxidant and antiinflammatory compounds are among these novel approaches. Pycnogenol (PYC) is a natural compound that could control inflammation and oxidative stress. Furthermore, some previous studies have shown that PYC could effectively reduce inflammation through signaling the downstream of insulin receptors, inhibiting the phosphorylation of the serine residues of insulin receptor substrate-1, reducing pro-inflammatory cytokines and oxidative stress indices through the stimulation of antioxidant pathways, increasing free radical scavenging activities, preventing lipid peroxidation, and protecting the erythrocytes in glucose-6-phosphate dehydrogenase-deficient individuals, although these effects have not been fully proved. The present study aimed to comprehensively review the evidence concerning the positive physiological and pharmacological properties of PYC, with an emphasis on the therapeutic potential of this natural component for enhancing human health.
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Affiliation(s)
- Elyas Nattagh-Eshtivani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Gheflati
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh Barghchi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pegah Rahbarinejad
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kadda Hachem
- Laboratory of Biotoxicology, Pharmacognosy and Biological Valorization of Plants (LBPVBP), Faculty of Sciences, University of Saida- Dr Moulay Tahar, Saida, Algeria
| | - Mohammed Nader Shalaby
- Biological Sciences and Sports Health Department, Faculty of Physical Education, Suez Canal University, Ismailia, Egypt
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Golnaz Ranjbar
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Dmitry Olegovich Bokov
- Institute of Pharmacy, Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Laboratory of Food Chemistry, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Pegah Rahimi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Naseh Pahlavani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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Zetterman T, Markkula R, Kalso E. Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity. Rheumatol Adv Pract 2022; 6:rkac053. [PMID: 35832286 PMCID: PMC9272915 DOI: 10.1093/rap/rkac053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/04/2022] [Indexed: 01/08/2023] Open
Abstract
Abstract
Objectives
Fibromyalgia (FM), a common pain syndrome, is thought to be a non-inflammatory, nociplastic condition, but evidence implicating neuroinflammation has been increasing. Systemic inflammation may be associated with more severe symptoms in some FM patients. We studied healthy controls and FM patients with and without systemic inflammation detectable using high-sensitivity CRP (hsCRP) measurement.
Methods
We measured hsCRP levels and gathered clinical and questionnaire data [including the Fibromyalgia Impact Questionnaire (FIQ)] from 40 female FM patients and 30 age-matched healthy women. An hsCRP level >3 mg/l was considered elevated.
Results
FM patients had significantly higher mean hsCRP levels than controls, explained by overweight and lower leisure-time physical activity. Eight FM patients had elevated hsCRP levels and 29 had normal hsCRP levels. Levels of hsCRP were significantly correlated with FIQ scores. Patients with elevated hsCRP had higher FIQ scores, with worse physical functioning and greater pain and were less likely to be employed than patients with normal hsCRP. These patient groups did not differ by blood count, liver function or lipid profiles, nor by education, psychological measures, sleep disturbance, smoking or comorbidities.
Conclusion
Some FM patients have elevated hsCRP, mostly due to overweight and physical inactivity. They have worse symptoms and their ability to work is impaired. Measurement of hsCRP may help to identify FM patients in greatest need of interventions supporting working ability.
Trial registration
ClinicalTrials.gov (https://clinicaltrials.gov), NCT03300635
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Affiliation(s)
- Teemu Zetterman
- Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital , Helsinki
- City of Vantaa Health Centre , Vantaa
- Department of General Practice and Primary Health Care
| | - Ritva Markkula
- Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital , Helsinki
| | - Eija Kalso
- Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital , Helsinki
- SLEEPWELL Research Programme, Faculty of Medicine, University of Helsinki , Helsinki, Finland
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Moreno-Torres V, Castejón R, Mellor-Pita S, Tutor-Ureta P, Durán-del Campo P, Martínez-Urbistondo M, Vázquez-Comendador J, Gutierrez-Rojas Á, Rosado S, Vargas-Nuñez JA. Usefulness of the hemogram as a measure of clinical and serological activity in systemic lupus erythematosus. J Transl Autoimmun 2022; 5:100157. [PMID: 35620179 PMCID: PMC9126956 DOI: 10.1016/j.jtauto.2022.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/30/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background and objectives Methods Results Conclusion RDW, NLR and PLR are higher in SLE patients than in the health patients. RDW correlates with SLEDAI-2k and SLICC/ACR scores, IL-6 and TNF. In anemic SLE patients, PLR reflects TNF activity. The value of these hematological indices supports SLE serological and clinical activity.
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Affiliation(s)
- Víctor Moreno-Torres
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
- Corresponding author. Unidad de Enfermedades Autoinmunes Sistémicas. Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana, C/ Joaquín Rodrigo nº 2. 28222, Majadahonda, Madrid, Spain.
| | - Raquel Castejón
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Susana Mellor-Pita
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Pablo Tutor-Ureta
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Pedro Durán-del Campo
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - María Martínez-Urbistondo
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - José Vázquez-Comendador
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Ángela Gutierrez-Rojas
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Silvia Rosado
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Juan A. Vargas-Nuñez
- Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
- Medicine Department, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain
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Dodzo RC, Ogunsakin RE, Ginindza TG. Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini. Afr J Prim Health Care Fam Med 2022; 14:e1-e9. [PMID: 35532109 PMCID: PMC9082230 DOI: 10.4102/phcfm.v14i1.3339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Anaemia is a global health problem affecting about a third of the world's population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries (LICs), 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy. AIM This study aimed to determine the prevalence and risks associated with anaemia amongst pregnant women attending antenatal clinic (ANC) in three health facilities in Eswatini. SETTING This study was conducted in three health facilities in Eswatini, namely Mankayane, Raleigh Fitkin Memorial (RFM) and Mbabane Hospital. METHODS This cross-sectional study used non-probability sampling in three hospitals of Eswatini, to select 550 pregnant women, aged 15-49 years. Data were collected from January to March 2021, using face-to-face interviews with a structured questionnaire. Logistic regression was used for statistical analysis. RESULTS A total of 550 pregnant women were included in the study. Anaemia prevalence amongst pregnant women was 43.1% with mild, moderate and severe cases of 21.3%; 21.1% and 0.7%, respectively. Prevalence was high amongst women aged 15-19 years (53.3%). Factors associated with anaemia included living in urban areas (odds ratio [OR]: 1.8; confidence interval [CI]: 1.19-2.72), having anaemia 6 months before pregnancy (OR: 4.64; CI: 1.15-18.71), and gestational age at first ANC: third trimester (OR = 10.42; CI: 4.27-25.4) and second trimester (OR: 1.62; CI: 1.02-2.60). CONCLUSION Anaemia remains prevalent amongst pregnant women in Eswatini. A comprehensive anaemia prevention programme would be justified and could lower the country's burden of anaemia.
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Affiliation(s)
- Rumbidzai C Dodzo
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Ministry of Health.
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Toe QK, Issitt T, Mahomed A, Almaghlougth F, Bahree I, Sturge C, Hu X, Panselinas I, Burke‐Gaffney A, Wort SJ, Quinlan GJ. Human pulmonary artery endothelial cells upregulate ACE2 expression in response to iron‐regulatory elements: potential implications for SARS‐CoV‐2 infection. Pulm Circ 2022; 12:e12068. [PMID: 35514788 PMCID: PMC9063967 DOI: 10.1002/pul2.12068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Abstract
Vascular endothelial cell dysfunction is reported in severe coronavirus disease 2019 disease, however, controversy exists regarding levels of angiotensin‐converting enzyme 2 (ACE2) expression, a coreceptor for severe acute respiratory syndrome coronavirus 2, in these cells. We report ACE2 expression and positive regulation by both interleuki‐6, hepcidin, and ferroportin knock‐down in pulmonary artery endothelial cells with potential implications for viral infection.
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Affiliation(s)
| | - Theo Issitt
- National Heart Lung Institute, Imperial College London
- University of York
| | - Abdul Mahomed
- National Heart Lung Institute, Imperial College London
| | | | - Ishan Bahree
- National Heart Lung Institute, Imperial College London
| | | | - Xueqi Hu
- National Heart Lung Institute, Imperial College London
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Exploration of the relationship between anemia and iron and zinc deficiencies in children under 5 years of age living in the malaria endemic area of South Kivu/Democratic Republic of Congo. Ann Hematol 2022; 101:1181-1189. [PMID: 35320403 DOI: 10.1007/s00277-022-04816-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/07/2022] [Indexed: 11/01/2022]
Abstract
The aim of this study was to explore the relationship of iron and zinc deficiencies and anemia in children aged under 5 years living in malaria endemic area of South Kivu/DRC. We conducted a cross-sectional study in the health zone of Miti Murhesa in South Kivu/DRC. A total of 1088 children in good general health were included in this study. Almost 40% of children were anemic. The prevalence of iron deficiency (ID) was found in 34.9% and 49.1% children based on ferritin or free erythrocyte protoporphyrin (FEP), respectively. If anemia is present, we found iron deficiency anemia (IDA) according to the WHO-criteria (ferritin) in 31%, and according to FEP in 66% of children. The overall prevalence of zinc deficiency was 17.6%. If anemia is present, zinc deficiency was found in 24.4% of children. Inflammation/infection, based upon CRP, was present in 39.7% children. The independent factors associated with anemia were recent illness, middle upper arm circumference, weight-for-height, ID according to FEP, zinc deficiency, and submicroscopic Plasmodium infection. A high prevalence of ID was observed in children in South Kivu according to FEP. Ferritin as acute phase protein was less suited in this population due to a high frequency of infection/inflammation. Iron and zinc deficiencies were found to be significantly associated with anemia in this population.
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Manrai M, Dawra S, Kapoor R, Srivastava S, Singh A. Anemia in cirrhosis: An underestimated entity. World J Clin Cases 2022; 10:777-789. [PMID: 35127894 PMCID: PMC8790443 DOI: 10.12998/wjcc.v10.i3.777] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/18/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity. Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute variceal hemorrhage but day-to-day management in hospital and out-patient raises multiple dilemmas: Whether anemia is a disease complication or a part of the disease spectrum? Should iron, folic acid, and vitamin B complex supplementation and nutritional advice, suffice in those who can perform tasks of daily living but have persistently low hemoglobin. How does one investigate and manage anemia due to multifactorial etiologies in the same patient: Acute or chronic blood loss because of portal hypertension and bone marrow aplasia secondary to hepatitis B or C viremia? To add to the clinician’s woes the prevalence of anemia increases with increasing disease severity. We thus aim to critically analyze the various pathophysiological mechanisms complicating anemia in a patient with cirrhosis with an emphasis on the diagnostic flowchart in such patients and proposed management protocols thereafter.
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Affiliation(s)
- Manish Manrai
- Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India
| | - Saurabh Dawra
- Department of Medicine and Gastroenterology, Command Hospital, Pune 411040, India
| | - Rajan Kapoor
- Department of Medicine, Command Hospital, Kolkata 70027, India
| | - Sharad Srivastava
- Department of Medicine and Gastroenterology, Command Hospital, Pune 411040, India
| | - Anupam Singh
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Suciadi LP, Henrina J, Putra ICS, Cahyadi I, Gunawan HFH. Chronic Heart Failure: Clinical Implications of Iron Homeostasis Disturbances Revisited. Cureus 2022; 14:e21224. [PMID: 35178308 PMCID: PMC8842304 DOI: 10.7759/cureus.21224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/05/2022] Open
Abstract
Iron deficiency is prevalent in chronic heart failure (CHF) patients. Nonetheless, the diagnosis is often overlooked and, often, the treatment is commenced just when overt anemia has ensued. Therefore, a better appreciation of this disease is needed, and all seasoned cardiologists should know how to approach CHF patients with iron deficiency correctly, as mandated by clinical practice guidelines. In this comprehensive review, we describe iron homeostasis, the pathophysiologic changes of iron homeostasis, and the clinical implications of iron deficiency on CHF patients. In addition, we delineate the evolution of clinical trials, ranging from the inception to the ongoing clinical trials of iron deficiency treatment in CHF patients. Iron deficiency contributes to the worse clinical outcome of the patients. Numerous studies have reported the clinical benefit of iron supplementation, particularly in intravenous preparation, in heart failure patients regarding symptoms, functional capacity, and quality of life (QoL) improvement. Therefore, the current guidelines recommend routine screening of iron status in all newly diagnosed heart failure patients. Eventually, intravenous iron replacement is recommended for symptomatic heart failure patients with iron deficiency, irrespective of anemia.
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Jin H, Chen P, Zhang S, Wu P, Yu X. Iron Metabolism Markers and Lower Extremity Arterial Disease in People with Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:3103-3110. [PMID: 36237965 PMCID: PMC9553230 DOI: 10.2147/dmso.s380803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine the levels of serum iron, ferritin, total iron-binding capacity, and hepcidin in patients with type 2 diabetes mellitus (T2DM), and to elucidate the relationship of these biomarkers with lower extremity arterial disease (LEAD). METHODS Three hundred fifteen patients with T2DM were selected for the study and divided into non-LEAD (n = 119) and LEAD groups (n=196) based on the ankle-brachial index (ABI) results. Demographic data and clinical test results were collected from all patients. Serum iron, ferritin, total iron-binding capacity, and hepcidin levels were measured, and the transferrin saturation was calculated. RESULTS Hepcidin levels were substantially higher in the LEAD group (19.17 ± 8.66 ng/mL) than the non-LEAD group (15.44±7.55 ng/mL, P < 0.001), and there was a negative correlation between the ABI and serum lecithin level (r = -0.349, P < 0.001). There were no other correlations with the other iron metabolism indicators. The results of dichotomous logistic regression with LEAD as the dependent variable revealed that smoking history (OR = 4.442, P = 0.008), hypertension history (OR = 3.721, P = 0.006), cardiovascular disease history (OR = 11.126, P < 0.001), diabetes duration (OR = 1.305, P < 0.001), age (OR = 1.056, P = 0.021), hs-CRP level (OR = 1.376, P = 0.002), HbA1c concentration (OR = 1.394, P = 0.001), and hepcidin level (OR = 1.097, P = 0.003) were independent risk factors for LEAD in T2DM patients. CONCLUSION Serum hepcidin levels were elevated in the LEAD group compared with the non-LEAD group, and elevated hepcidin levels were associated with the development of LEAD in T2DM patients, suggesting that hepcidin may be involved in the occurrence and development of LEAD in T2DM patients.
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Affiliation(s)
- Hua Jin
- Department of Endocrinology and Metabolism, Fengxian Central Hospital, Shanghai, 201404, People’s Republic of China
| | - Peihong Chen
- Department of Endocrinology and Metabolism, Fengxian Central Hospital, Shanghai, 201404, People’s Republic of China
| | - Shan Zhang
- Department of Endocrinology and Metabolism, Fengxian Central Hospital, Shanghai, 201404, People’s Republic of China
| | - Ping Wu
- Department of Endocrinology and Metabolism, Fengxian Central Hospital, Shanghai, 201404, People’s Republic of China
| | - Xuemei Yu
- Department of Endocrinology and Metabolism, Fengxian Central Hospital, Shanghai, 201404, People’s Republic of China
- Correspondence: Xuemei Yu, Department of Endocrinology and Metabolism, Fengxian Central Hospital, No. 6600, Nanfeng Road, Nanqiaoxincheng, Fengxian District, Shanghai, 201404, People’s Republic of China, Tel +86 21-57413468, Email
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Hematopoiesis and innate immunity: an inseparable couple for good and bad times, bound together by an hormetic relationship. Leukemia 2022; 36:23-32. [PMID: 34853440 PMCID: PMC8727304 DOI: 10.1038/s41375-021-01482-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 12/13/2022]
Abstract
Hematopoietic and immune cells originate from a common hematopoietic/lymphopoietic stem cell what explains that these different cell types often share the same receptors and respond to similar factors. Moreover, the common goal of both lineages is to ensure tissue homeostasis under steady-state conditions, fight invading pathogens, and promote tissue repair. We will highlight accumulating evidence that innate and adaptive immunity modulate several aspects of hematopoiesis within the hormetic zone in which the biological response to low exposure to potential stressors generally is favorable and benefits hematopoietic stem/progenitor cells (HSPCs). Innate immunity impact on hematopoiesis is pleiotropic and involves both the cellular arm, comprised of innate immunity cells, and the soluble arm, whose major component is the complement cascade (ComC). In addition, several mediators released by innate immunity cells, including inflammatory cytokines and small antimicrobial cationic peptides, affect hematopoiesis. There are intriguing observations that HSPCs and immune cells share several cell-surface pattern-recognition receptors (PRRs), such as Toll-like receptors (TLRs) and cytosol-expressed NOD, NOD-like, and RIG-I-like receptors and thus can be considered "pathogen sensors". In addition, not only lymphocytes but also HSPCs express functional intracellular complement proteins, defined as complosome which poses challenging questions for further investigation of the intracellular ComC-mediated intracrine regulation of hematopoiesis.
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Al-Okbi SY, Mabrok HB, Al-Siedy ESK, Mohamed RS, Ramadan AA. Iron status, immune system, and expression of brain divalent metal transporter 1 and dopamine receptors D1 interrelationship in Parkinson’s disease and the role of grape seed and green coffee bean extracts and quercetin in mitigating the disease in rats. JOURNAL OF HERBMED PHARMACOLOGY 2021. [DOI: 10.34172/jhp.2022.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Parkinson’s disease (PD) is a neurodegenerative disease with a prevalence of 1% in the elderly worldwide. The aim of the research is to study the interrelationship of iron status, the immune system including inflammatory cytokines, brain divalent metal transporter 1 (DMT1), and dopamine receptors D1 (DRD1) in a PD rat model. The potential protective effects of grape seed and green coffee bean ethanol extracts and quercetin were also studied. Methods: Phenolic and flavonoid contents of grape seed and green coffee bean and in vitro free radicals scavenging activities of the extracts and quercetin were determined. Male rats were divided into five groups. Group 1 served as normal control (NC), group 2 represented Parkinsonian control (PC). Groups 3, 4, and 5 were the test groups treated by daily oral green coffee bean, grape seed extracts, and quercetin, respectively. PD was induced by rotenone in groups 2 to 5. Brain oxidative stress, DMT1, and DRD1 expressions, and histopathology were assessed. Parameters of the immune system, represented by plasma interferon-gamma (IFNγ) and CD4, and brain tumor necrosis factor-alpha (TNF-α) along with iron status were also determined. Results: Phenolic and flavonoid contents of green coffee bean were high compared to grape seed (P < 0.05). Quercetin experienced the highest in-vitro free radicals scavenging activities. Iron deficiency anemia, together with elevated IFNγ, TNF-α, DMT1 expressions, and brain malondialdehyde (MDA) were demonstrated in PC compared to NC (P < 0.05). Also, reduction in CD4 and brain reduced-glutathione (GSH) (P < 0.05) were noticed in PC with brain histopathological alterations. Different treatments showed variable improvements in the majority of parameters (P < 0.05) and brain histopathology. Conclusion: Iron deficiency anemia might result from cytokine elevation in PD. Reduced DRD1 and altered immune system including cytokines together with increased brain DMT1 might induce neurodegeneration in PD. Different treatments showed variable neuroprotective effects through modulation of inflammation, oxidative stress, immune system, iron status, DMT1, and DRD1.
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Affiliation(s)
| | - Hoda Bakr Mabrok
- Nutrition and Food Sciences Department, National Research Centre, Cairo, Egypt
| | | | - Rasha Salah Mohamed
- Nutrition and Food Sciences Department, National Research Centre, Cairo, Egypt
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Correlation Analysis between Hemoglobin and C-Reactive Protein in Patients Admitted to an Emergency Unit. J Clin Med 2021; 10:jcm10225411. [PMID: 34830693 PMCID: PMC8622244 DOI: 10.3390/jcm10225411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Anemia and inflammation are common clinical conditions in emergency departments. This study explored a cohort of patients admitted to the emergency department with a particular interest in determining the frequency of anemia and inflammation and the association between hemoglobin (Hb) and C-reactive protein (CRP) concentrations. The study included 125 patients categorized according to their demographic (gender and age) and clinical condition (Hb and CRP concentrations, pathological background, and diagnostic). We found that anemia and inflammation were simultaneously present in 36.0% of the cohort, reaching 67.0% in patients that were subsequently hospitalized. The Hb level was significantly lower in patients with elevated concentration of CRP when compared to individuals with normal CRP levels (11.58 ± 2.23 vs. 13.25 ± 1.80, p = 0.001); furthermore, we found a significantly negative correlation between Hb concentration and the CRP level (rs = −0.42, p < 0.001). The linear regression model applied to the cohort showed that CRP levels explain 15% of Hb variations. The sensitivity of the CRP/Hb ratio (cut-off = 1.32) as a predictor of hospitalization was 80.0%, with a specificity of 68.4% for all patients. These findings confirmed the prevalence of anemia and inflammation and identified a moderate but significant association between Hb and serum CRP in a heterogeneous group of patients admitted to the emergency department.
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Rana S, Prabhakar N. Iron disorders and hepcidin. Clin Chim Acta 2021; 523:454-468. [PMID: 34755647 DOI: 10.1016/j.cca.2021.10.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 12/13/2022]
Abstract
Iron is an essential element due to its role in a wide variety of physiological processes. Iron homeostasis is crucial to prevent iron overload disorders as well as iron deficiency anemia. The liver synthesized peptide hormone hepcidin is a master regulator of systemic iron metabolism. Given its role in overall health, measurement of hepcidin can be used as a predictive marker in disease states. In addition, hepcidin-targeting drugs appear beneficial as therapeutic agents. This review emphasizes recent development on analytical techniques (immunochemical, mass spectrometry and biosensors) and therapeutic approaches (hepcidin agonists, stimulators and antagonists). These insights highlight hepcidin as a potential biomarker as well as an aid in the development of new drugs for iron disorders.
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Affiliation(s)
- Shilpa Rana
- Department of Biochemistry, Sector-25, Panjab University, Chandigarh 160014, India
| | - Nirmal Prabhakar
- Department of Biochemistry, Sector-25, Panjab University, Chandigarh 160014, India.
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Assey EV, Sadiq AM, Swai MJ, Sadiq AM, Dekker MCJ. Idiopathic Arachnoiditis of the Cauda Equina: A Case Report from Tanzania. Case Rep Neurol 2021; 13:535-540. [PMID: 34720959 PMCID: PMC8460926 DOI: 10.1159/000518379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/06/2021] [Indexed: 11/19/2022] Open
Abstract
Arachnoiditis is a rare clinical entity that usually presents with severe debilitating radiating pain that can pose a challenge in diagnosis especially in areas without appropriate imaging modalities. We present a 26-year-old male with progressive lower back pain with radiation to the lower extremities, aggravated by movement and touch. We diagnosed idiopathic arachnoiditis based on cerebrospinal fluid analysis and magnetic resonance imaging. He was managed with a 5-day course of methylprednisolone and analgesics with a good outcome. Severe back pain without a specific cause in a young patient should be investigated with proper imaging modalities and lumbar puncture if warranted to evaluate the cause.
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Affiliation(s)
- Emmanuel V Assey
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Abid M Sadiq
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Magreth J Swai
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Adnan M Sadiq
- Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Marieke C J Dekker
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Handono K, Wahono CS, Pratama MZ, Kalim H. Association of the premature immunosenescence with the presence and severity of anemia among patients with systemic lupus erythematosus. Lupus 2021; 30:1906-1914. [PMID: 34720016 DOI: 10.1177/09612033211038057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION One of the possible mechanisms that contribute to the development of anemia in systemic lupus erythematosus (SLE) is the presence of premature immunosenescence in SLE. This study aimed to observe the correlation between immunosenescence with anemia in SLE. METHODS This research was a cross-sectional study with the subject was 60 women with SLE aged 16-45 years old. Subjects were recorded for the demographic and clinical data, complete blood counts, iron status (iron serum, total iron-binding capacity, and transferrin saturation), ferritin, inflammatory markers (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]), and anti-dsDNA levels. Immunosenescence was observed by measuring the senescent T cells from peripheral blood mononuclear cells (PBMC) by flow cytometry, counted as CD4+CD57+ and CD8+CD57+ T cells. Serum IL-2 and IFNγ as the cytokines associated with immunosenescence were also measured from all subjects. Subjects were divided into anemic and non-anemic groups according to the classification of anemia from WHO (Hb < 12 gr/dl). RESULTS Anemic SLE patients had higher CD4+CD57+, CD8+CD57+, and IFNγ, while IL-2 was lower in SLE patients with anemia. Multivariate linear regression revealed that the decreasing levels of Hb were associated with the increase of CD8+CD57+ percentages and IFNγ levels. Anti-dsDNA, ESR, CRP, ferritin, iron serum, and transferrin saturation were correlated with CD8+CD57+. IFNγ level also correlated with the anti-dsDNA, iron serum, and ferritin levels. No correlation was found between the iron status and inflammatory markers with CD4+CD57+ percentages and IL-2 levels. Multivariate regression analysis showed that IFNγ was positively associated with anti-dsDNA and negatively associated with iron serum and transferrin saturation, while CD8+CD57+ percentages were positively associated with the ferritin levels. CONCLUSION Immunosenescence is associated with anemia by modulating the inflammatory response and causing iron dysregulation in SLE.
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Affiliation(s)
- Kusworini Handono
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Cesarius Singgih Wahono
- Rheumatology and Immunology Division, Department of Internal Medicine, Facuty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Mirza Zaka Pratama
- Rheumatology and Immunology Division, Department of Internal Medicine, Facuty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Handono Kalim
- Rheumatology and Immunology Division, Department of Internal Medicine, Facuty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
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Bhattacharya S, Kalra S, Kapoor N, Singla R, Dutta D, Aggarwal S, Khandelwal D, Surana V, Dhingra A, Kantroo V, Chittawar S, Deka N, Bindal V, Dutta P. Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery. World J Diabetes 2021; 12:1587-1621. [PMID: 34754367 PMCID: PMC8554368 DOI: 10.4239/wjd.v12.i10.1587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/18/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) and obesity are interrelated in a complex manner, and their coexistence predisposes patients to a plethora of medical problems. Metabolic surgery has evolved as a promising therapeutic option for both conditions. It is recommended that patients, particularly those of Asian origin, maintain a lower body mass index threshold in the presence of uncontrolled DM. However, several comorbidities often accompany these chronic diseases and need to be addressed for successful surgical outcome. Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used bariatric procedures worldwide. The bariatric benefits of RYGB and LSG are similar, but emerging evidence indicates that RYGB is more effective than LSG in improving glycemic control and induces higher rates of long-term DM remission. Several scoring systems have been formulated that are utilized to predict the chances of remission. A glycemic target of glycated hemoglobin < 7% is a reasonable goal before surgery. Cardiovascular, pulmonary, gastrointestinal, hepatic, renal, endocrine, nutritional, and psychological optimization of surgical candidates improves perioperative and long-term outcomes. Various guidelines for preoperative care of individuals with obesity have been formulated, but very few specifically focus on the concerns arising from the presence of concomitant DM. It is hoped that this statement will lead to the standardization of presurgical management of individuals with DM undergoing metabolic surgery.
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Affiliation(s)
| | - Sanjay Kalra
- Endocrinology, Bharti Hospital, Karnal 132001, Haryana, India
| | - Nitin Kapoor
- Endocrinology, Christian Medical College, Vellore 632004, Tamil Nadu, India
| | - Rajiv Singla
- Endocrinology, Kalpavriksh Super Speciality Center, New Delhi 110075, India
| | - Deep Dutta
- Endocrinology, CEDAR Superspecialty Clinic, New Delhi 110075, India
| | - Sameer Aggarwal
- Endocrinology, Apex Plus Superspeciality Hospital, Rohtak 124001, Haryana, India
| | | | - Vineet Surana
- Endocrinology, Manipal Hospitals, New Delhi 110075, India
| | - Atul Dhingra
- Endocrinology, Gangaram Bansal Super Speciality Hospital, Sri Ganganagar 335001, Rajasthan, India
| | - Viny Kantroo
- Respiratory Medicine & Critical Care, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
| | - Sachin Chittawar
- Endocrinology, Gandhi Medical College, Bhopal 462001, Madhya Pardesh, India
| | - Nilakshi Deka
- Endocrinology, Apollo Hospitals, Guwahati 781005, Assam, India
| | - Vivek Bindal
- Minimal Access, Metabolic and Bariatric surgery, Max Superspeciality Hospital, Patparganj, New Delhi 110092, India
| | - Puja Dutta
- Nutrition, Max Superspeciality Hospital, Patparganj, New Delhi 110092, India
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50
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Oliveira BGRBD, Castro JBDA, Lisboa EFNS, Kang HC, Ferreira MDA. The presence of anemia in patients with leg ulcer: laboratory test. Rev Bras Enferm 2021; 75:e20210064. [PMID: 34614085 DOI: 10.1590/0034-7167-2021-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. METHOD This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. RESULTS 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. CONCLUSION The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.
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Affiliation(s)
| | | | | | - Hye Chung Kang
- Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil
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