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Gayathri N, Kumar MV, Vinoth T, Prabhu R, Krishnabharath S. Correlation of Liver and Myocardium Iron Concentration Determined by Magnetic Resonance Imaging With Serum Ferritin in Non-Transfusion-Dependent Thalassemia Patients. Cureus 2022; 14:e27467. [PMID: 36060401 PMCID: PMC9420837 DOI: 10.7759/cureus.27467] [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: 07/27/2022] [Indexed: 11/05/2022] Open
Abstract
Background The primary factor associated with fatality in thalassemia patients is heavy cardiac complications. Currently, magnetic resonance imaging (MRI) is accepted as the non-invasive modality of choice for diagnosing iron overload in the liver. This study aimed to correlate liver iron concentration (LIC) and myocardium iron concentration (MIC) determined by MRI and clinical and biochemical parameters in non-transfusion-dependent thalassemia (NTDT) patients. Methodology This prospective study was conducted in the radiology department from October 2016 to September 2018. A total of 30 patients were included. Using Siemens MAGNETOM® Avanto 1.5T, iron was quantified with a body matrix coil. Sequences performed were gradient-echo 8 and 12 for the myocardium and liver, respectively. Dual-echo fast spoiled gradient-echo in/out phase and diffusion-weighted images were used. Iron values were calculated using T2* spreadsheet analysis software version 3.1. Data were analyzed using coGuide software V.1.03. Results The mean age of the participants was 24.9 ± 12.6 years. There was a very strong positive correlation between LIC and serum ferritin. There was a strong negative correlation between LIC and hemoglobin. Between LIC and MIC, there was a marginally favorable relationship (rs value = 0.077, p-value = 0.985). Conclusions When MRI is not available, serum ferritin can be used as an alternative to diagnose iron overload in patients with NTDT.
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Huang Y, Yang G, Wang M, Wei X, Pan L, Liu J, Lei Y, Peng, Long L, Lai Y, Liu R. Iron overload status in patients with non-transfusion-dependent thalassemia in China. Ther Adv Hematol 2022; 13:20406207221084639. [PMID: 35321211 PMCID: PMC8935562 DOI: 10.1177/20406207221084639] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Iron overload is one of the main factors that increase morbidity and mortality in patients with non-transfusion dependent thalassemia (NTDT). Aim: This study aimed at investigating the prevalence and severity of iron overload in Chinese NTDT patients. Methods: we analyzed serum ferritin (SF), liver iron concentration (LIC) and cardiac T2* in 178 Chinese NTDT in this cross-sectional study. Results: The median SF level was 996.00(27.15–19704.00) ng/ml and the median LIC value was 8.90(0.60–43.00) mg Fe/g dry weight (dw). The youngest patient with liver iron overload was 5 years old with 5.6 mg Fe/g dw in LIC. The median cardiac T2* was 33.06(7.46–75.08) ms. 6 patients had cardiac T2*⩽20ms. The patients with β thalassemia intermedia and HbE/β thalassemia showed a statistically significant lower Hb and higher values of SF and LIC than those of hemoglobin H disease patients. On multivariate logistic regression analysis, patients in ⩾ age 30-year old had a significant higher risk for iron overload (OR: 77.75, 95% CI: 8.76–690.49) in the age group. The detailed analysis of proportions of different LIC indicate in > 30-year old group, 76.8% patients suffered from moderate and severe LIC. Conclusion: Our study provides a strong support for the novel findings that Chinese NTDT patients have a high prevalence of iron overload. The first assessment of MRI LIC should be performed as early as 5 years old. Then, NTDT patients > 30 years old may suffer with a high burden of iron overload.
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Affiliation(s)
- Yumei Huang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Gaohui Yang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Man Wang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoyun Wei
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lingyuan Pan
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiaodi Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yu Lei
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Peng
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yongrong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Rongrong Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
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Zaman BA, Rasool SO, Merza MA, Abdulah DM. Hepcidin-to-ferritin ratio: A potential novel index to predict iron overload-liver fibrosis in ß-thalassemia major. Transfus Clin Biol 2021; 29:153-160. [PMID: 34856399 DOI: 10.1016/j.tracli.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES We aimed to determine a threshold cutoff for hepcidin, ferritin, and the hepcidin-to-ferritin ratio in the diagnosis of liver fibrosis caused by iron overload in chronic hepatitis C virus (HCV)-free ß-thalassemia major patients . METHODS This 1:1-matched case-control study included 102 individuals (3-30 yr.); 51 ß-thalassemia major patients with iron overload , and 51 apparently healthy individuals. RESULTS The highest areas under the receiver operating characteristic curves (AUC-ROCs) for the diagnosis of patients vs. controls had overlapping 95% confidence intervals (CIs): serum hepcidin (0.758; 0.64-0.87; P ˂ 0.001), serum ferritin (1.000; 1.00-1.00; P˂0.001), and the hepcidin/ferritin ratio (1.000; 1.00-1.00; P˂0.001). For differentiation of patients with liver fibrosis stages of F0-F1 vs. F2-F4 and F0-F1 vs. F3-F4, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) with P-values˂0.001 were the only statistically significant parameters, while the AUC-ROCs of the hepcidin/ferritin ratio (0.631, P=0.188 and 0.684, P=0.098) exhibited 90% and 89.5% sensitivity, respectively, in staging liver fibrosis. CONCLUSION Our results showed that the hepcidin/ferritin ratio is as effective as the APRI and maybe a better predictor for the diagnosis of liver fibrosis and discriminating its stages, with excellent sensitivity and specificity compared to its components.
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Affiliation(s)
- B A Zaman
- Department of Pharmacology, College of Pharmacy, University of Duhok, Kurdistan region, Iraq.
| | - S O Rasool
- Department of Clinical Pharmacy, College of Pharmacy, University of Duhok, Kurdistan region, Iraq.
| | - M A Merza
- Azadi Teaching Hospital, Department of Internal Medicine, College of Pharmacy, University of Duhok, Kurdistan region, Iraq.
| | - D M Abdulah
- Community Health Unit, College of Nursing, University of Duhok, Kurdistan region, Iraq.
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Lobo A, Liu Y, Song Y, Liu S, Zhang R, Liang H, Xin H. Effect of procyanidins on lipid metabolism and inflammation in rats exposed to alcohol and iron. Heliyon 2020; 6:e04847. [PMID: 32964156 PMCID: PMC7490533 DOI: 10.1016/j.heliyon.2020.e04847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/24/2020] [Accepted: 09/01/2020] [Indexed: 02/06/2023] Open
Abstract
Background Lifestyle involving uncontrolled alcohol consumption coupled regularly with red meat and other iron sources has detrimental effects on the liver, which in the long term, results in Alcoholic Liver Disease (ALD). Procyanidin has lately garnered increasing attention and has become the focus of research owing to its antioxidant properties. This study explores the anti-inflammatory effects of procyanidins, in preventing ALD, by analyzing the biological activities of the compound on liver injury caused by excessive alcohol and iron. Method Male SPF Wistar rats were placed in 4 groups; the control Group A (basic diet); the model Group B (excess alcohol 8–12 mL/kg/d and iron 1000 mg/kg diet); the low dose procyanidin Group C (model group diet plus 60 mg/kg/d of procyanidin); and the high dose procyanidin Group D (model group diet plus 120 mg/kg/d of procyanidin). Serum biochemical markers for liver damage were measured spectrophotometrically. The NFκB and IκB mRNA expression levels were determined using RT-PCR; the NFκB p65 and IκB protein expression levels were assessed via western blotting, while ELISA was used to detect serum inflammatory factors. Results The pathological score of the model Group B, low and high dose procyanidin Groups C and D were 6.58 ± 0.90,4.69 ± 0.70 and 2.00 ± 0.73, respectively (P < 0.05). The results showed that high alcohol and iron contents in the model group led to significant damage of liver structure, increased low-density lipoproteins (LDLs), steatosis, and increased levels of inflammatory cytokines. High amounts of procyanidins led to the preservation of the liver structure, production of high-density lipoproteins, and reduction in serum inflammatory cytokines while also significantly decreasing the expression levels of NFκB p65. Conclusion The results prove that procyanidins have hepatoprotective potential and could be effective in reversing histopathology, possibly by alleviating inflammation and improving lipid metabolism.
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Affiliation(s)
- Amara Lobo
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 16 Jiang Su Road, Qingdao 266071, China
| | - Ying Liu
- Basic Medical College, Qingdao University, 38 Deng Zhou Road, Qingdao 266021, China
| | - Yuqing Song
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 16 Jiang Su Road, Qingdao 266071, China
| | - Song Liu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 16 Jiang Su Road, Qingdao 266071, China
| | - Rui Zhang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 16 Jiang Su Road, Qingdao 266071, China
| | - Hui Liang
- Department of Human Nutrition, College of Public Health, Qingdao University, 38 Deng Zhou Road, Qingdao 266021, China
| | - Hui Xin
- Department of Cardiology, The Affiliated Hospital of Qingdao University, 16 Jiang Su Road, Qingdao 266071, China
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Amjad F, Fatima T, Fayyaz T, Khan MA, Qadeer MI. Novel genetic therapeutic approaches for modulating the severity of β-thalassemia (Review). Biomed Rep 2020; 13:48. [PMID: 32953110 PMCID: PMC7484974 DOI: 10.3892/br.2020.1355] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/13/2020] [Indexed: 12/13/2022] Open
Abstract
Thalassemia is a genetic haematological disorder that arises due to defects in the α and β-globin genes. Worldwide, 0.3-0.4 million children are born with haemoglobinopathies per year. Thalassemic patients, as well as their families, face various serious clinical, socio-economic, and psychosocial challenges throughout their life. Different therapies are available in clinical practice to minimize the suffering of thalassemic patients to some extent and potentially cure the disease. Predominantly, patients undergo transfusion therapy to maintain their haemoglobin levels. Due to multiple transfusions, the iron levels in their bodies are elevated. Iron overload results in damage to body organs, resulting in heart failure, liver function failure or endocrine failure, all of which are commonly observed. Certain drugs have been developed to enhance the expression of the γ-gene, which ultimately results in augmentation of fetal haemoglobin (HbF) levels and total haemoglobin levels in the body. However, its effectiveness is dependent on the genetic makeup of the individual patient. At present, allogeneic haematopoietic Stem Cell Transplantation (HSCT) is the only practically available option with a high curative rate. However, the outcome of HSCT is strongly influenced by factors such as age at transplantation, irregular iron chelation history before transplantation, histocompatibility, and source of stem cells. Gene therapy using the lentiglobin vector is the most recent method for cure without any mortality, graft rejection and clonal dominance issues. However, delayed platelet engraftment is being reported in some patients. Genome editing is a novel approach which may be used to treat patients with thalassemia; it makes use of targeted nucleases to correct the mutations in specific DNA sequences and modify the sequence to the normal wild-type sequence. To edit the genome at the required sites, CRISPR/Cas9 is an efficient and accurate tool that is used in various genetic engineering programs. Genome editing mediated by CRISPR/Cas9 has the ability to restore the normal β-globin function with minimal side effects. Using CRISPR/Cas9, expression of BCL11A can be downregulated along with increased production of HbF. However, these genome editing tools are still under in-vitro trials. CRISPR/Cas9 has can be used for precise transcriptional regulation, genome modification and epigenetic editing. Additional research is required in this regard, as CRISPR/Cas9 may potentially exhibit off-target activity and there are legal and ethical considerations regarding its use.
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Affiliation(s)
- Fareeha Amjad
- Department of Microbiology and Molecular Genetics, University of The Punjab, Lahore, Punjab 54590, Pakistan
| | - Tamseel Fatima
- Department of Microbiology and Molecular Genetics, University of The Punjab, Lahore, Punjab 54590, Pakistan
| | - Tuba Fayyaz
- Department of Microbiology and Molecular Genetics, University of The Punjab, Lahore, Punjab 54590, Pakistan
| | - Muhammad Aslam Khan
- Sundas Molecular Analysis Centre (SUNMAC), Sundas Foundation, Lahore, Punjab 54000, Pakistan
| | - Muhammad Imran Qadeer
- Department of Microbiology and Molecular Genetics, University of The Punjab, Lahore, Punjab 54590, Pakistan.,Sundas Molecular Analysis Centre (SUNMAC), Sundas Foundation, Lahore, Punjab 54000, Pakistan
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Akatsu H, Manabe T, Kawade Y, Tanaka H, Kanematsu T, Arakawa K, Masaki Y, Hishida C, Kanesaka T, Ogawa N, Hashizume Y, Tsuneyama K, Ohara H, Maruyama M, Yamamoto T. Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. PLoS One 2020; 15:e0237104. [PMID: 32750083 PMCID: PMC7402501 DOI: 10.1371/journal.pone.0237104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background Vitamins and minerals are routinely administered by total parenteral nutrition (TPN). However, in Japan, adjustments in iron dosage are difficult because blended mineral preparations are often used. It is therefore unclear whether the iron content is appropriate in cases of long-term TPN. The aim of the study was to assess the influence of iron administration by long-term TPN on iron deposition in post-mortem liver samples isolated from older deceased patients. Methods Liver tissues were collected from post-mortem autopsies of 187 patients over a period of 15 years. Samples were stained with Prussian blue and histologically evaluated from Grade 0–V by at least three different observers. Specimens with positive and negative iron staining were compared, and positive samples were grouped according to the level and distribution of the staining. Post-mortem blood obtained from the subclavian vein during autopsy was also analysed. Samples were collected for the measurement of unsaturated serum iron, serum iron, albumin, prealbumin, hepcidin, and IL-6 concentrations. Results Iron accumulation in the liver was significantly higher in male patients (p = 0.005) with a history of surgery (p = 0.044) or central vein administration of iron (p<0.001). Additionally, the duration of TPN in the iron-positive group was significantly longer than in the iron-negative group (p = 0.038). Serum analysis revealed that unsaturated serum iron was significantly higher in the iron-negative group and that ferritin and serum iron were significantly higher in the iron-positive group. No other statistically significant differences were observed between the two groups. Conclusions Chronic intravenous administration of iron was associated with iron deposition in the liver, even when given the minimum recommended dosage. In long-term TPN patients, the iron dose should therefore be carefully considered.
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Affiliation(s)
- Hiroyasu Akatsu
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Fukushimura Hospital, Toyohashi, Japan
- Department of Mechanism of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- * E-mail: ,
| | - Toshie Manabe
- Division of Community and Family Medicine, Center of Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yoshihiro Kawade
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hajime Tanaka
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takayoshi Kanematsu
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazuyuki Arakawa
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshiyuki Masaki
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | | | | - Koichi Tsuneyama
- Department of Pathology, Tokushima University School of Medicine, Tokushima, Japan
| | - Hirotaka Ohara
- Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mitsuo Maruyama
- Department of Mechanism of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Hepcidin and Erythroferrone Correlate with Hepatic Iron Transporters in Rats Supplemented with Multispecies Probiotics. Molecules 2020; 25:molecules25071674. [PMID: 32260496 PMCID: PMC7180848 DOI: 10.3390/molecules25071674] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 12/15/2022] Open
Abstract
The influence of probiotic supplementation on iron metabolism remains poorly investigated. However, a range of studies, especially on Lactobacillus plantarum 299v (Lp229v), have indicated a possible positive impact of probiotics on iron absorption. The aim of the study was to determine the effect of multistrain probiotic supply on iron balance. Thirty Wistar rats were randomized into three groups: placebo (KK group), and multistrain probiotic per os in a daily dose of 2.5 × 109 colony forming units (CFU) (PA group) or 1 × 1010 CFU (PB group). Multistrain probiotic consisted of nine bacterial strains: Bifidobacterium bifidum W23, B. lactis W51, B. lactis W52, Lactobacillus acidophilus W37, L. brevis W63, L. casei W56, L. salivarius W24, Lactococcus lactis W19, and Lc. lactis W58, in equal proportions. After six weeks, blood and organ samples were collected. No differences were found between the three groups in terms of serum concentrations of hepcidin (HEPC), lactoferrin (LTF), homocysteine (HCY), ferritin (Ft), or erythroferrone (ErFe), or in liver content of divalent metal transporter 1 (DMT1), transferrin receptors 1 and 2 (TfR), or ZRT/IRT-like protein 14 (ZIP14) proteins. In the overall sample, positive correlations were noted between the serum concentrations of hepcidin and lactoferrin, and hepcidin and ferritin; serum concentration of hepcidin and DMT1 and TfR1 in the liver; and serum concentration of erythroferrone and TfR2 in the liver. The correlations of serum hepcidin and erythroferrone with liver DMT1 and TfR represent significant mechanisms of Fe homeostasis. Our study has shown that multistrain probiotic supplementation used in the experiment did not disrupt the biochemical and hepatic regulatory processes of Fe balance and did not demonstrate significant influence on selected parameters of Fe metabolism.
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Ravikanth R, Pinto D, Majumdar P. Extensive periportal fibrosis due to hepatic iron overload masquerading as mass lesions in a beta-thalassemia major patient: Sonological appearances. APOLLO MEDICINE 2020. [DOI: 10.4103/am.am_35_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Protective Effect of Astragaloside IV on Hepatic Injury Induced by Iron Overload. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3103946. [PMID: 31428632 PMCID: PMC6683835 DOI: 10.1155/2019/3103946] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/16/2019] [Indexed: 12/20/2022]
Abstract
Suitable content of iron is essential for human body, but iron overload is associated with many kinds of diseases including chronic liver damage. Recently, researchers find that iron overload promotes hepatocyte autophagy and apoptosis. However, the mechanism of iron overload in liver damage remains unclear. In this study, Lo2 cells were selected as the research object, iron dextran was a model drug, and astragaloside IV was a therapeutic drug to explore the role of iron overload. MTT assay and Annexin/PI double staining were used to measure cell viability and apoptosis. Ultrastructure was observed by transmission electron microscopy. The expression levels of apoptosis and autophagy-related proteins were determined by real-time PCR and Western Blot. The results showed that iron dextran could significantly inhibit Lo2 cell viability and increase the apoptosis rate, while astragaloside IV could reverse the inhibition of Lo2 cell viability and decrease the apoptosis rate. Transmission electron microscopy showed a significant increase in the number of autophagosomes after administration of iron dextran, and the application of astragaloside IV reduced the production of autophagosomes. LC3II/I was significantly upregulated in the model group but decreased in the astragaloside IV treatment group, and P62 showed the opposite trend. Iron dextran significantly upregulated the expression of Bax and downregulated Bcl2, while astragaloside IV reversed this trend. Finally, the inhibition of hepcidin caused by iron dextran was counteracted by astragaloside IV. In conclusion, the experimental results show that the iron overload model mainly induces excessive autophagy and apoptosis of hepatocytes, thus causing damage to hepatocytes, but astragaloside IV plays a certain therapeutic role in reversing this damage.
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Vassalle C, Meloni A, Pistoia L, Gamberini MR, Spasiano A, Gerardi C, Zuccarelli A, Casini T, Righi R, Missere M, Positano V, Ndreu R, Pepe A. Relationship between uric acid levels and cardiometabolic findings in a large cohort of β-thalassemia major patients. Biomark Med 2018; 12:341-348. [PMID: 29569468 DOI: 10.2217/bmm-2017-0300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
AIM to evaluate the relationship between uric acid (UA), hepatic and cardiac iron overload (T2*-MRI), ferritin, endocrinological diseases and cardiac complications in a large thalassemia major (TM) cohort. METHODS A total of 369 TM patients (187 men; 33 ± 6 years) were retrospectively studied, from the myocardial iron overload in thalassemia (MIOT) electronic databank. RESULTS Multiple regression model identified male sex (p < 0.001), BMI (p < 0.001) and T2* (p ≤ 0.001) as UA independent correlates. Moreover, UA and derivatives of reactive oxygen species (an oxidative index; r = -0.3; p ≤ 0.05) are inversely correlated. Conversely, the multivariate logistic analysis identified low UA (NANHES-III criteria) as one independent predictor for low global heart T2* (p < 0.5) together with liver iron concentrations (>3 mg/g/dw), heart failure, endocrinopathies, ferritin (>2000 ng/l), alanine transaminase (>40 UI/l) and/or aspartate transaminase (>35 UI/l) and/or glutamyl transferase (>64 UI/l). DISCUSSION UA appears directly associated to T2* and inversely with derivatives of reactive oxygen species, and as such reduced according to increased oxidative stress and cardiac iron overload in TM patients.
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Affiliation(s)
- Cristina Vassalle
- Medicina di laboratorio, Fondazione CNR-Regione Toscana G Monasterio, Pisa, Italy
| | - Antonella Meloni
- MRI Unit, Fondazione CNR-Regione Toscana G Monasterio, Pisa, Italy
| | - Laura Pistoia
- MRI Unit, Fondazione CNR-Regione Toscana G Monasterio, Pisa, Italy
| | - Maria Rita Gamberini
- Unità Operativa di Day Hospital della Talassemia e delle Emoglobinopatie-Dipartimento della Riproduzione e dell'Accrescimento, Azienda Ospedaliero-Universitaria 'S Anna', Ferrara, Italy
| | - Anna Spasiano
- Unità Operativa Semplice Dipartimentale Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale 'A Cardarelli', Napoli, Italy
| | - Calogera Gerardi
- Unità Operativa Semplice di Talassemia, Presidio Ospedaliero 'Giovanni Paolo II' - Distretto AG2 di Sciacca, Sciacca, Italy
| | - Angelo Zuccarelli
- UO Medicina trasfusionale, ATS Sardegna-ASSL Carbonia, Carbonia, Italy
| | - Tommaso Casini
- Centro Talassemie ed Emoglobinopatie, Ospedale 'Meyer', Firenze, Italy
| | - Riccardo Righi
- Diagnostica per Immagini e Radiologia Interventistica, Ospedale del Delta, Lagosanto (FE), Italy
| | - Massimiliano Missere
- Dipartimento di Immagini, Fondazione di Ricerca e Cura 'Giovanni Paolo II', Campobasso, Italy
| | | | - Rudina Ndreu
- Medicina di laboratorio, Fondazione CNR-Regione Toscana G Monasterio, Pisa, Italy
| | - Alessia Pepe
- MRI Unit, Fondazione CNR-Regione Toscana G Monasterio, Pisa, Italy
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