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Alvarenga AM, Brissot P, Santos PCJL. Haemochromatosis revisited. World J Hepatol 2022; 14:1931-1939. [PMID: 36483608 PMCID: PMC9724105 DOI: 10.4254/wjh.v14.i11.1931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/27/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
Haemochromatosis is a genetic disease caused by hepcidin deficiency, responsible for an increase in intestinal iron absorption. Haemochromatosis is associated with homozygosity for the HFE p.Cys282Tyr mutation. However, rare cases of haemochromatosis (non-HFE haemochromatosis) can also be caused by pathogenic variants in other genes (such as HJV, HAMP, TFR2 and SLC40A1). A working group of the International Society for the Study of Iron in Biology and Medicine (BIOIRON Society) has concluded that the classification based in different molecular subtypes is difficult to be adopted in clinical practice and has proposed a new classification approaching clinical questions and molecular complexity. The aim of the present review is to provide an update on classification, pathophysiology and therapeutic recommendations.
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Affiliation(s)
- Aline Morgan Alvarenga
- Department of Pharmacology - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil
| | | | - Paulo Caleb Junior Lima Santos
- Department of Pharmacology - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil
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Acevedo LAU, Alvarenga AM, Fonseca PFS, da Silva NK, Cançado RD, Naoum FA, Dinardo CL, Pereira AC, Brissot P, Santos PCJL. Quality of Life Scores Remained Different among the Genotypic Groups of Patients with Suspected Hemochromatosis, Even after Treatment Period. Genes (Basel) 2022; 13:genes13010118. [PMID: 35052458 PMCID: PMC8774363 DOI: 10.3390/genes13010118] [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: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Hemochromatosis is a genetic condition of iron overload caused by deficiency of hepcidin. In a previous stage of this study, patients with suspected hemochromatosis had their quality of life (QL) measured. We observed that QL scores differed among genotypic groups of patients. In this reported final phase of the study, the aims were to compare QL scores after a treatment period of approximately 3 years and to analyze a possible association of the serum ferritin values with QL scores. Methods: Sixty-five patients were enrolled in this final phase and divided into group 1 (patients that showed primary iron overload and homozygous genotype for the HFE p.Cys282Tyr mutation) and group 2 (other kinds of genotypes). Short Form 36 (SF-36) was performed and consisted of eight domains with a physical and also a mental component. Results: Both groups had a significant decrease in serum ferritin concentrations: group 1 had a variation from 1844 ± 1313 ng/mL to 281 ± 294 ng/mL, and group 2 had a variation from 1216 ± 631 ng/mL to 236 ± 174 ng/mL. Group 1 had a smaller mean value for these six SF-36 domains compared with group 2, indicating a worse QL. Conclusions: In this final stage, six domains demonstrated a difference among genotypic groups (role emotional and mental health, adding to the four of the initial phase), reassuring the impact of the identified genotype on the QL of hemochromatosis patients. Furthermore, despite that both patient groups demonstrated similar and significant decreases in serum ferritin values, no association was found between the decrease in this biological parameter and the SF-36 domains.
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Affiliation(s)
- Luis Alfredo Utria Acevedo
- Department of Pharmacology—Escola Paulista de Medicina, Universidade Federal de Sao Paulo (EPM-Unifesp), Sao Paulo 05403-904, Brazil; (L.A.U.A.); (A.M.A.); (N.K.d.S.)
| | - Aline Morgan Alvarenga
- Department of Pharmacology—Escola Paulista de Medicina, Universidade Federal de Sao Paulo (EPM-Unifesp), Sao Paulo 05403-904, Brazil; (L.A.U.A.); (A.M.A.); (N.K.d.S.)
| | - Paula Fernanda Silva Fonseca
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo 05403-904, Brazil; (P.F.S.F.); (A.C.P.)
| | - Nathália Kozikas da Silva
- Department of Pharmacology—Escola Paulista de Medicina, Universidade Federal de Sao Paulo (EPM-Unifesp), Sao Paulo 05403-904, Brazil; (L.A.U.A.); (A.M.A.); (N.K.d.S.)
| | | | | | - Carla Luana Dinardo
- Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil, Universidade de São Paulo (USP), Sao Paulo 05403-904, Brazil;
| | - Alexandre Costa Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo 05403-904, Brazil; (P.F.S.F.); (A.C.P.)
| | - Pierre Brissot
- Institut NuMeCan, Inserm U-1241, Univ Rennes 1, 35000 Rennes, France;
| | - Paulo Caleb Junior Lima Santos
- Department of Pharmacology—Escola Paulista de Medicina, Universidade Federal de Sao Paulo (EPM-Unifesp), Sao Paulo 05403-904, Brazil; (L.A.U.A.); (A.M.A.); (N.K.d.S.)
- Correspondence:
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Cancado RD, Alvarenga AM, Santos PCJ. HFE hemochromatosis: an overview about therapeutic recommendations. Hematol Transfus Cell Ther 2021; 44:95-99. [PMID: 34824033 PMCID: PMC8885398 DOI: 10.1016/j.htct.2021.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 06/12/2021] [Accepted: 06/24/2021] [Indexed: 11/17/2022] Open
Abstract
Hemochromatosis is currently characterized by the iron overload caused by hepcidin deficiency. Large advances in the knowledge on the hemochromatosis pathophysiology have occurred due to a better understanding of the protein of the iron metabolism, the genetic basis of hemochromatosis and of other iron overload diseases or conditions which can lead to this phenotype. In the present review, the main aims are to show updates on hemochromatosis and to report a practical set of therapeutic recommendations for the human factors engineering protein (HFE) hemochromatosis for the p.Cys282Tyr (C282Y/C282Y) homozygous genotype, elaborated by the Haemochromatosis International Taskforce.
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Affiliation(s)
- Rodolfo D Cancado
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | | | - Paulo Caleb Jl Santos
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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