Léčba karboxymaltózou železa (FCM) zmírňuje příznaky a zlepšuje kvalitu života u pacientů se srdečním selháním se sníženou ejekční frakcí levé komory (EF LK) a nedostatkem železa. Studie HEART‐FID byla zaměřena na další důkazy o vlivu FCM na klinické příhody. Její výsledky doložily, že u pacientů trpících srdečním selháním se sníženou EF LK a nedostatkem železa nebyl patrný rozdíl mezi skupinami s FCM a s placebem s ohledem na složený primární cílový ukazatel − úmrtí, hospitalizace pro srdeční selhání nebo změna vzdálenosti v šestiminutovém testu chůzí.
The treatment with ferric carboxymaltose (FCM) alleviates the symptoms and improves the quality of life in patients suffering from heart failure with reduced left ventricular ejection fraction (HFrEF) and iron deficiency. The HEART‐FID study dealt with new data concerning the relationship between FCM use and clinical events. As for the composite primary endpoint (comprising deaths, hospitalizations for HF and changes in a 6 minute walk test), this study showed that FCM compared to placebo did not improve outcomes in patients with HFrEF and iron deficiency.
- Klíčová slova
- studie HEART-FID, karboxymaltóza železa,
- MeSH
- deficit železa * farmakoterapie prevence a kontrola MeSH
- dospělí MeSH
- ferritiny analýza krev MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- sloučeniny železa farmakologie klasifikace terapeutické užití MeSH
- systolické srdeční selhání * diagnóza farmakoterapie mortalita MeSH
- test chůzí klasifikace metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
Cílem post hoc analýzy studie ASPREE bylo zjistit vliv nízkých dávek kyseliny acetylsalicylové (ASA) na anémii, koncentraci hemoglobinu a sérového feritinu. Studie prokázala, že nízké dávky ASA zvyšují výskyt anémie a působí pokles koncentrace feritinu u jinak zdravých starších dospělých nezávisle na závažném krvácení. U starších osob užívajících ASA je třeba zvážit pravidelné monitorování koncentrace hemoglobinu.
The aim of the post hoc analysis of data obtained in the ASPREE trial was to evaluate the impact of low‐dose acetylsalicylic acid (ASA) on the development of anemia, hemoglobin concentration, and serum ferritin levels. The trial showed that low‐dose ASA increased the risk of anemia and caused hemoglobin concentration decrease in otherwise healthy senior adults independently of the occurrence of serious bleeding. Regular hemoglobin concentration monitoring should be contemplated in senior patients treated with ASA.
BACKGROUND: Data on the clinical significance of iron deficiency (ID) in patients with myocardial infarction (MI) are conflicting. This may be related to the use of various ID criteria. We aimed to compare the association of different ID criteria with all-cause mortality after MI. METHODS: Consecutive patients hospitalized for their first MI at a large tertiary heart center were included. We evaluated the association of different iron metabolism parameters measured on the first day after hospital admission with all-cause mortality. RESULTS: From the 1,156 patients included (aged 64±12 years, 25 % women), 194 (16.8 %) patients died during the median follow-up of 3.4 years. After multivariate adjustment, iron level ≤13 μmol/L (HR 1.67, 95 % CI 1.19-2.34) and the combination of iron level ≤12.8 μmol/L and soluble transferrin receptor (sTfR) ≥3 mg/L (HR 2.56, 95 % CI 1.64-3.99) termed as PragueID criteria were associated with increased mortality risk and had additional predictive value to the GRACE score. Compared to the model including iron level, the addition of sTfR improved risk stratification (net reclassification improvement 0.61, 95 % CI 0.52-0.69) by reclassifying patients into a higher-risk group. No association between ferritin level and mortality was found. 51 % of patients had low iron levels, and 58 % fulfilled the PragueID criteria. CONCLUSION: Iron deficiency is common among patients with the first MI. The PragueID criteria based on iron and soluble transferrin receptor levels provide the best prediction of mortality and should be evaluated in future interventional studies for the identification of patients potentially benefiting from intravenous iron therapy.
- MeSH
- anemie z nedostatku železa * mortalita MeSH
- deficit železa MeSH
- ferritiny krev MeSH
- hospitalizace MeSH
- infarkt myokardu * mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- příčina smrti MeSH
- proporcionální rizikové modely MeSH
- receptory transferinu krev MeSH
- rizikové faktory MeSH
- senioři MeSH
- železo * krev MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Susceptibility to COVID-19, the most devastating global pandemic, appears to vary widely across different population groups. Exposure to toxoplasmosis has been proposed as a theory to explain the diversity of these populations. The aim of the present study was to investigate the possible association between latent toxoplasmosis and COVID-19 and its probable correlation with markers of oxidative stress, C-reactive protein (CRP) and ferritin. In a case-control study, blood samples were collected from 91 confirmed (48 non-pneumonic; NP, and 43 pneumonic; P) COVID-19 patients and 45 healthy controls. All participants were tested for IgG anti-Toxoplasma gondii antibodies and oxidative stress markers (nitric oxide [NO], superoxide dismutase [SOD] and reduced glutathione [GSH]), and CRP and serum ferritin levels were determined. In COVID-19 patients, IgG anti-T. gondii antibodies were found in 54% compared to 7% in the control group, with the difference being statistically significant (P ˂ 0.001). However, no significant correlation was found between the severity of COVID-19 and latent T. gondii infection. Latent toxoplasmosis had a strong influence on the risk of COVID-19. NO and SOD levels were significantly increased in COVID-19 patients, while GSH levels decreased significantly in them compared to control subjects (P ˂ 0.001 for both values). CRP and ferritin levels were also significantly elevated in P COVID-19 patients infected with toxoplasmosis. This is the first study to look at the importance of oxidative stress indicators in co-infection between COVID-19 and T. gondii. The high prevalence of latent toxoplasmosis in COVID-19 suggests that T. gondii infection can be considered a strong indicator of the high risk of COVID-19.
- MeSH
- biologické markery MeSH
- COVID-19 * MeSH
- ferritiny MeSH
- imunoglobulin G MeSH
- lidé MeSH
- oxid dusnatý MeSH
- oxidační stres MeSH
- protilátky protozoální MeSH
- rizikové faktory MeSH
- séroepidemiologické studie MeSH
- studie případů a kontrol MeSH
- superoxiddismutasa MeSH
- toxoplazmóza * epidemiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- karboxymaltóza železa,
- MeSH
- ambulantní infuzní terapie MeSH
- deficit železa diagnóza etiologie MeSH
- ferritiny analýza krev účinky léků MeSH
- komorbidita MeSH
- lidé MeSH
- maltosa aplikace a dávkování terapeutické užití MeSH
- srdeční selhání * etiologie patofyziologie terapie MeSH
- webová vysílání jako téma MeSH
- železité sloučeniny aplikace a dávkování terapeutické užití MeSH
- železo metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
BACKGROUND: Iron deficiency in athletes is initially treated with a nutritional intervention. If negative iron balance persists, oral iron supplementation (OIS) can be used. Despite the recent proposal for a refinement of treatment strategies for iron-deficient athletes, there is no general consensus regarding the actual efficiency, dosage, or optimal regimen of OIS. OBJECTIVE: The aim of this meta-analysis was to evaluate to what extent OIS affects blood iron parameters and physical performance in healthy adult athletes. METHODS: PubMed, Web of Science, PEDro, CINAHL, SPORTDiscus, and Cochrane were searched from inception to 2 November 2022. Articles were eligible if they satisfied the following criteria: recruited subjects were healthy, adult and physically active individuals, who used exclusively OIS, irrespective of sex and sports discipline. EXCLUSION CRITERIA: simultaneous supplementation with iron and any other micronutrient(s), intravenous iron supplementation or recent exposure to altitude acclimatisation. The methodological quality of included studies was assessed with the PEDro scale, the completeness of intervention reporting with the TIDieR scale, while the GRADE scale was used for quality of evidence synthesis. The present study was prospectively registered in PROSPERO online registry (ID: CRD42022330230). RESULTS: From 638 articles identified through the search, 13 studies (n = 449) were included in the quantitative synthesis. When compared to the control group, the results demonstrated that OIS increases serum ferritin (standardized mean difference (SMD) = 1.27, 95% CI 0.44-2.10, p = 0.006), whereas blood haemoglobin (SMD = 1.31, 95% CI - 0.29 to 2.93, p = 0.099), serum transferrin receptor concentration (SMD = - 0.74, 95% CI - 1.89 to 0.41, p = 0.133), and transferrin saturation (SMD = 0.69, 95% CI - 0.84 to 2.22, p = 0.330) remained unaltered. Following OIS, a trend of small positive effect on VO2max (SMD = 0.49, 95% CI - 0.09 to 1.07, p = 0.086) was observed in young healthy athletes. The quality of evidence for all outcomes ranged from moderate to low. CONCLUSIONS: Increase in serum ferritin concentration after OIS was evident in subjects with initial pre-supplementation serum ferritin concentration ≤ 12 μg/l, while only minimal, if any effect, was observed in subjects with higher pre-supplementation serum ferritin concentration. The doses of OIS, that induced a beneficial effect on hematological parameters differed from 16 to 100 mg of elementary iron daily, over the period between 6 and 8 weeks. Shorter supplementation protocols have been shown to be ineffective.
- MeSH
- anemie z nedostatku železa farmakoterapie krev MeSH
- aplikace orální MeSH
- ferritiny krev MeSH
- hemoglobiny analýza metabolismus MeSH
- lidé MeSH
- potravní doplňky * MeSH
- randomizované kontrolované studie jako téma * MeSH
- sportovci MeSH
- sportovní výkon fyziologie MeSH
- železo * aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
Souhrn: Hereditární hemochromatóza patří mezi onemocnění, při kterých se nadměrně hromadí železo v těle, a patří mezi nejčastější vrozená metabolická onemocnění. Kazuistika prezentuje případ pacienta s akutním krvácením do horní části gastrointestinálního traktu, se zvýšenou hodnotou sérového železa a feritinu, bez elevace bilirubinu, transamináz nebo obstrukčních jaterních testů, u něhož byla dalším došetřením zjištěna genetická hemochromatóza.
Summary: Hereditary hemochromatosis is a disease in which iron accumulates excessively in the body and it is one of the most common congenital metabolic diseases. The case report presents a patient from practice with acute upper gastrointestinal bleeding, with increased serum iron and ferritin values, without elevation in bilirubin, transaminases or obstructive liver tests, in whom further examination revealed genetic hemochromatosis.
- MeSH
- cytaferéza metody MeSH
- diferenciální diagnóza MeSH
- erytrocyty MeSH
- ferritiny analýza krev MeSH
- gastrointestinální krvácení diagnóza etiologie farmakoterapie MeSH
- hemochromatóza * diagnóza genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace MeSH
- protein hemochromatózy genetika MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
In this study we use comparative genomics to uncover a gene with uncharacterized function (1700011H14Rik/C14orf105/CCDC198), which we hereby name FAME (Factor Associated with Metabolism and Energy). We observe that FAME shows an unusually high evolutionary divergence in birds and mammals. Through the comparison of single nucleotide polymorphisms, we identify gene flow of FAME from Neandertals into modern humans. We conduct knockout experiments on animals and observe altered body weight and decreased energy expenditure in Fame knockout animals, corresponding to genome-wide association studies linking FAME with higher body mass index in humans. Gene expression and subcellular localization analyses reveal that FAME is a membrane-bound protein enriched in the kidneys. Although the gene knockout results in structurally normal kidneys, we detect higher albumin in urine and lowered ferritin in the blood. Through experimental validation, we confirm interactions between FAME and ferritin and show co-localization in vesicular and plasma membranes.
INTRODUCTION: Major clinically relevant inflammatory events such as septic shock and severe COVID-19 trigger dynamic changes in the host immune system, presenting promising candidates for new biomarkers to improve precision diagnostics and patient stratification. Hepcidin, a master regulator of iron metabolism, has been intensively studied in many pathologies associated with immune system activation, however these data have never been compared to other clinical settings. Thus, we aimed to reveal the dynamics of iron regulation in various clinical settings and to determine the suitability of hepcidin and/or ferritin levels as biomarkers of inflammatory disease severity. COHORTS: To investigate the overall predictive ability of hepcidin and ferritin, we enrolled the patients suffering with three different diagnoses - in detail 40 patients with COVID-19, 29 patients in septic shock and eight orthopedic patients who were compared to nine healthy donors and all cohorts to each other. RESULTS: We showed that increased hepcidin levels reflect overall immune cell activation driven by intrinsic stimuli, without requiring direct involvement of infection vectors. Contrary to hepcidin, ferritin levels were more strongly boosted by pathogen-induced inflammation - in septic shock more than four-fold and in COVID-19 six-fold in comparison to sterile inflammation. We also defined the predictive capacity of hepcidin-to-ferritin ratio with AUC=0.79 and P = 0.03. DISCUSSION: Our findings confirm that hepcidin is a potent marker of septic shock and other acute inflammation-associated pathologies and demonstrate the utility of the hepcidin-to-ferritin ratio as a predictor of mortality in septic shock, but not in COVID-19.
- MeSH
- biologické markery MeSH
- COVID-19 * MeSH
- ferritiny MeSH
- hepcidiny metabolismus MeSH
- lidé MeSH
- septický šok * MeSH
- zánět MeSH
- železo metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Od prosince 2019 se onemocněním COVID-19 nakazily stovky milionů lidí na celém světě, avšak závažné příznaky se objevily u 20 % nebo méně. Hlavním cílem této studie bylo posoudit vztah mezi závažností onemocnění COVID-19 a různými klinickými a laboratorními parametry. Do tohoto prospektivního souboru se ochotně zapojilo celkem 466 Arabů. Z celkového počtu mělo 297 osob (63,7 %) negativní test na COVID-19, a byly tedy zařazeny jako kontroly, zatímco 169 osob (36,3 %), u nichž byl test na COVID-19 pozitivní, bylo zařazeno jako případy. Z celkového počtu pacientů s COVID-19 mělo 127 pacientů (75,15 %) mírné příznaky a 42 pacientů (24,85 %) mělo závažné příznaky. Věkové rozmezí účastníků bylo 20 až 82 let. V porovnání s kontrolní skupinou byla závažnost onemocnění spojena s významně vyššími hladinami feritinu (P < 0,001). Závažnost onemocnění byla rovněž spojena s významným zvýšením C-reaktivního proteinu (P < 0,001), D-dimerů (P < 0,001), počtu bílých krvinek (WBC) (P < 0,01), IgM (P < 0,001) a granulocytů (P < 0,01). Kromě toho byly závažné příznaky COVID-19 v této studii spojeny s významným poklesem lymfocytů (P < 0,01). U pacientů s COVID-19, kteří se při přijetí prezentovali závažnými příznaky, došlo ke čtyřnásobnému zvýšení hladiny feritinu v séru. Ten byl spojen s významně vyššími hladinami CRP a D-dimerů. Hyperferitinémie spolu s vysokými koncentracemi CRP a D-dimerů tak mohou sloužit jako spolehlivé prediktory závažnosti onemocnění a špatné prognózy u Arabů s COVID-19.
Worldwide, hundreds of millions of people have been infected with COVID-19 since December 2019; however, about 20% or less developed severe symptoms. The main aim of the current study was to assess the relationship between the severity of Covid-19 and different clinical and laboratory parameters. A total number of 466 Arabs have willingly joined this prospective cohort. Out of the total number, 297 subjects (63.7%) had negative COVID-19 tests, and thus, they were recruited as controls, while 169 subjects (36.3%) who tested positive for COVID-19 were enrolled as cases. Out of the total number of COVID-19 patients, 127 (75.15%) presented with mild symptoms, and 42 (24.85%) had severe symptoms. The age range for the participants was 20 to 82 years. Compared with controls, the severity of the disease was associated with significantly high ferritin levels (P < 0.001). The severity of the disease was also associated with a significant increase in C-reactive protein (P < 0.001), D-dimer (P < 0.001), white blood cell count (WBC) (P < 0.01), IgM (P < 0.001), and Granulocytes (P < 0.01). In addition, severe COVID-19 symptoms in the current study were associated with a significant decrease in lymphocytes (P < 0.01). There was a four-fold increase in serum ferritin levels in COVID-19 patients presented with severe symptoms upon admission. The former was associated with significantly high levels of CRP and D-dimer. Thus, hyperferritinemia, together with high CRP and D-dimer concentrations, may serve as reliable predictors for disease severity and poor prognosis in Arabs with COVID-19.
