- Publication type
- Meeting Abstract MeSH
Patients with alcoholic liver disease (ALD) often display disturbed iron indices. Hepcidin, a key regulator of iron metabolism, has been shown to be down-regulated by alcohol in cell lines and animal models. This down-regulation led to increased duodenal iron transport and absorption in animals. In this study, we investigated gene expression of duodenal iron transport molecules and hepcidin in three groups of patients with ALD (with anaemia, with iron overload and without iron overload) and controls. Expression of DMT1, FPN1, DCYTB, HEPH, HFE and TFR1 was measured in duodenal biopsies by using real-time PCR and Western blot. Serum hepcidin levels were measured by using ELISA. Serum hepcidin was decreased in patients with ALD. At the mRNA level, expressions of DMT1, FPN1 and TFR1 genes were significantly increased in ALD. This pattern was even more pronounced in the subgroups of patients without iron overload and with anaemia. Protein expression of FPN1 paralleled the increase at the mRNA level in the group of patients with ALD. Serum ferritin was negatively correlated with DMT1 mRNA. The down-regulation of hepcidin expression leading to up-regulation of iron transporters expression in the duodenum seems to explain iron metabolism disturbances in ALD. Alcohol consumption very probably causes suppression of hepcidin expression in patients with ALD.
- MeSH
- Liver Diseases, Alcoholic metabolism MeSH
- Cytochrome b Group genetics metabolism MeSH
- Adult MeSH
- Duodenum metabolism MeSH
- Gene Expression MeSH
- Hepcidins physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Membrane Proteins genetics metabolism MeSH
- Oxidoreductases genetics metabolism MeSH
- Cation Transport Proteins genetics metabolism MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Case-Control Studies MeSH
- Iron blood MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Publication type
- Meeting Abstract MeSH
- Publication type
- Meeting Abstract MeSH
Disturbances of iron metabolism are observed in chronic liver diseases. In the present study, we examined gene expression of duodenal iron transport molecules and hepcidin in patients with hereditary hemochromatosis (HHC) (treated and untreated), involving various genotypes (genotypes which represent risk for HHC were examined), and in patients with iron deficiency anaemia (IDA). Gene expressions of DMT1, ferroportin, Dcytb, hephaestin, HFE and TFR1 were measured in duodenal biopsies using real-time PCR and Western blot. Serum hepcidin levels were measured using ELISA. DMT1, ferroportin and TFR1 mRNA levels were significantly increased in post-phlebotomized hemochromatics relative to controls. mRNAs of all tested molecules were significantly increased in patients with IDA compared to controls. The protein expression of ferroportin was increased in both groups of patients but not significantly. Spearman rank correlations showed that DMT1 versus ferroportin, Dcytb versus hephaestin and DMT1 versus TFR1 mRNAs were positively correlated regardless of the underlying cause, similarly to protein levels of ferroportin versus Dcytb and ferroportin versus hephaestin. Serum ferritin was negatively correlated with DMT1 mRNA in investigated groups of patients, except for HHC group. A decrease of serum hepcidin was observed in IDA patients, but this was not statistically significant. Our data showed that although untreated HHC patients do not have increased mRNA levels of iron transport molecules when compared to normal subjects, the expression is relatively increased in relation to body iron stores. On the other hand, post-phlebotomized HHC patients had increased DMT1 and ferroportin mRNA levels possibly due to stimulated erythropoiesis after phlebotomy.
- MeSH
- Biological Transport MeSH
- Iron Deficiencies MeSH
- Adult MeSH
- Duodenum metabolism MeSH
- Phenotype MeSH
- Hemochromatosis blood genetics metabolism MeSH
- Antimicrobial Cationic Peptides blood metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- RNA, Messenger genetics metabolism MeSH
- Cation Transport Proteins genetics metabolism MeSH
- Gene Expression Regulation MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Case-Control Studies MeSH
- Iron metabolism MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVES: To assess the outcome of self-expandable, biodegradable stent insertion for anastomotic strictures following treatment for rectosigmoid carcinoma. METHODS: Three male patients (median age 66) developed benign strictures after radiotherapy and resection of a recto-sigmoid carcinoma. These were resistant to balloon dilatation and prevented stoma reversal. Biodegradable stent insertion was performed as an experimental treatment on a named-patient basis with approval of the institutional review board. Patients had monthly follow-up with endoscopy and contrast medium enemas to monitor performance and degradation of the stents. RESULTS: All stents were placed successfully without complications after pre-dilatation to 20 mm under fluoroscopic guidance. Stent degradation occurred in all patients 4-5 months following implantation, and long-term anastomotic patency was demonstrated in all. This allowed reversal of the colostomy and physiological defecation in two patients. Reversal was not undertaken in one due to subsequent development of liver metastases. No stent migration or occlusion occurred. CONCLUSIONS: Biodegradable stents can maintain an adequate lumen across anastomotic strictures resistant to balloon dilatation. They seem to allow stricture re-modelling resulting in maintained dilatation after degradation. This potentially allows reversal of a colostomy, which might otherwise be prevented by stricture recurrence.
- MeSH
- Anastomosis, Surgical adverse effects methods MeSH
- Risk Assessment MeSH
- Catheterization methods adverse effects MeSH
- Colectomy adverse effects methods MeSH
- Colostomy adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Rectal Neoplasms pathology surgery MeSH
- Follow-Up Studies MeSH
- Retreatment MeSH
- Polydioxanone MeSH
- Aged MeSH
- Neoplasm Staging MeSH
- Constriction, Pathologic etiology therapy MeSH
- Stents MeSH
- Absorbable Implants MeSH
- Treatment Outcome MeSH
- Sampling Studies MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Iron accumulation as seen in genetic haemochromatosis is a major cause of hepatic fibrogenesis. A link between chronic liver disease and Dupuytren's disease (DD) is well established, especially in alcoholics.
- MeSH
- Cholesterol blood MeSH
- Diabetes Mellitus metabolism MeSH
- Adult MeSH
- Dupuytren Contracture etiology genetics surgery metabolism MeSH
- Financing, Organized MeSH
- Hemochromatosis genetics complications metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Mutation MeSH
- Liver Diseases complications MeSH
- Alcohol Drinking adverse effects MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Occupations MeSH
- Iron metabolism MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- MeSH
- Esophageal and Gastric Varices therapy MeSH
- Humans MeSH
- Liver Diseases MeSH
- Emergency Medicine MeSH
- Check Tag
- Humans MeSH
- Publication type
- Book Review MeSH
