BACKGROUND: Dysmetabolic iron overload syndrome (DIOS) is characterized by hyperferritinemia and normal transferrin saturation level with components of metabolic syndrome (MS). Among cases of MS, we determined those with DIOS and their characterizations, then we evaluated the association between plasma catecholamines status and hypertension in DIOS. METHODS: We compared 101 hypertensive patients with 50 healthy participants (control group). Iron (iron, transferrin, and ferritin), insulin, and plasma catecholamine (adrenaline, noradrenaline, and dopamine), profiles were measured for both groups. Homeostasis model assessment of insulin resistance index and transferrin saturation were also calculated. RESULTS: Out of 101 hypertensive patients, 64 were diagnosed with MS, and 6 of the latter met the DIOS diagnostic criteria. Significantly, DIOS patients were older and had lower body mass index (BMI) compared with hypertensive non-DIOS patients with p-values of (0.026), and (0.033), respectively. Adrenaline, noradrenaline, and dopamine levels did not differ significantly between DIOS and non-DIOS patients. CONCLUSIONS: Of the MS patients, 9.3% were diagnosed with DIOS. Accordingly, complete iron profiling should be performed routinely in the cases of MS for early diagnosis of DIOS, to prevent future complications. Further studies are required to test the hypothesis linking older age and lower BMI with the pathogenesis of DIOS.
Thalassemias are a heterogeneous group of red blood cell disorders, considered a major cause of morbidity and mortality among genetic diseases. However, there is still no universally available cure for thalassemias. The underlying basis of thalassemia pathology is the premature apoptotic destruction of erythroblasts causing ineffective erythropoiesis. In β-thalassemia, β-globin synthesis is reduced causing α-globin accumulation. Unpaired globin chains, with heme attached to them, accumulate in thalassemic erythroblasts causing oxidative stress and the premature cell death. We hypothesize that in β-thalassemia heme oxygenase (HO) 1 could play a pathogenic role in the development of anemia and ineffective erythropoiesis. To test this hypothesis, we exploited a mouse model of β-thalassemia intermedia, Th3/+ We observed that HO inhibition using tin protoporphyrin IX (SnPP) decreased heme-iron recycling in the liver and ameliorated anemia in the Th3/+ mice. SnPP administration led to a decrease in erythropoietin and increase in hepcidin serum levels, changes that were accompanied by an alleviation of ineffective erythropoiesis in Th3/+ mice. Additionally, the bone marrow from Th3/+ mice treated with SnPP exhibited decreased heme catabolism and diminished iron release as well as reduced apoptosis. Our results indicate that the iron released from heme because of HO activity contributes to the pathophysiology of thalassemia. Therefore, new therapies that suppress heme catabolism may be beneficial in ameliorating the anemia and ineffective erythropoiesis in thalassemias.
- MeSH
- beta-talasemie krev komplikace farmakoterapie patologie MeSH
- erythropoetin krev MeSH
- erytropoéza účinky léků MeSH
- hemoxygenasa-1 analýza antagonisté a inhibitory MeSH
- inhibitory enzymů terapeutické užití MeSH
- játra účinky léků patologie MeSH
- metaloporfyriny terapeutické užití MeSH
- modely nemocí na zvířatech MeSH
- myši inbrední C57BL MeSH
- myši MeSH
- přetížení železem krev komplikace farmakoterapie patologie MeSH
- protoporfyriny terapeutické užití MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Iron is both an essential and a potentially toxic element, and its systemic homeostasis is controlled by the iron hormone hepcidin. Hepcidin binds to the cellular iron exporter ferroportin, causes its degradation, and thereby diminishes iron uptake from the intestine and the release of iron from macrophages. Given that hepcidin-resistant ferroportin mutant mice show exocrine pancreas dysfunction, we analysed pancreata of aging hepcidin knockout (KO) mice. Hepcidin and Hfe KO mice were compared with wild-type (WT) mice kept on standard or iron-rich diets. Twelve-month-old hepcidin KO mice were subjected to daily minihepcidin PR73 treatment for 1 week. Six-month-old hepcidin KO mice showed cytoplasmic acinar iron overload and mild pancreatitis, together with elevated expression of the iron uptake mediators DMT1 and Zip14. Acinar atrophy, massive macrophage infiltration, fatty changes and pancreas fibrosis were noted in 1-year-old hepcidin KO mice. As an underlying mechanism, 6-month-old hepcidin KO mice showed increased pancreatic oxidative stress, with elevated DNA damage, apoptosis and activated nuclear factor-κB (NF-κB) signalling. Neither iron overload nor pancreatic damage was observed in WT mice fed iron-rich diet or in Hfe KO mice. Minihepcidin application to hepcidin KO mice led to an improvement in general health status and to iron redistribution from acinar cells to macrophages. It also resulted in decreased NF-κB activation and reduced DNA damage. In conclusion, loss of hepcidin signalling in mice leads to iron overload-induced chronic pancreatitis that is not seen in situations with less severe iron accumulation. The observed tissue injury can be reversed by hepcidin supplementation. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
- MeSH
- acinární buňky metabolismus MeSH
- apoptóza fyziologie MeSH
- chronická pankreatitida etiologie metabolismus patologie MeSH
- cytoplazma metabolismus MeSH
- hepcidiny nedostatek genetika fyziologie MeSH
- makrofágy patologie MeSH
- modely nemocí na zvířatech MeSH
- myši inbrední C57BL MeSH
- myši knockoutované MeSH
- oxidační stres fyziologie MeSH
- pankreas ultrastruktura MeSH
- přetížení železem komplikace metabolismus patologie MeSH
- transmisní elektronová mikroskopie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
There is scarce evidence regarding the use of iron chelators in patients with hereditary hemochromatosis who are intolerant of phlebotomy or erythrocytapheresis. A 52-year-old man with genetically confirmed HFE hemochromatosis presented with liver disease and heart failure with severe left ventricular systolic dysfunction. Because of anemia after initial treatment, we added intravenous deferoxamine followed by oral deferiprone to less frequent erythrocytapheresis, which normalized systolic function within 1 year. Repeated cardiac magnetic resonance imaging revealed improvement of the T2* relaxation time. This report illustrates the beneficial effect of iron chelators in individuals with HFE hemochromatosis and poor tolerance of erythrocytapheresis.
- MeSH
- chelátory železa aplikace a dávkování MeSH
- deferoxamin aplikace a dávkování MeSH
- dysfunkce levé srdeční komory diagnóza etiologie MeSH
- ferritin analýza MeSH
- hemochromatóza * krev diagnóza farmakoterapie patofyziologie MeSH
- kardiomyopatie * diagnóza etiologie patofyziologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonance kinematografická metody MeSH
- nemoci jater diagnóza etiologie MeSH
- přetížení železem krev komplikace MeSH
- protein hemochromatózy genetika MeSH
- pyridony aplikace a dávkování MeSH
- srdeční selhání * diagnóza farmakoterapie etiologie MeSH
- stupeň závažnosti nemoci MeSH
- tepový objem MeSH
- transferin analýza MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The role of oxidative stress in the initiation and progression of myelodysplastic syndromes (MDS) as a consequence of iron overload remains unclear. In this study we have simultaneously quantified plasma low-molecular-weight aminothiols, malondialdehyde, nitrite, and nitrate and have studied their correlation with serum iron/ferritin levels, patient treatment (chelation therapy), and clinical outcomes. We found significantly elevated plasma levels of total, oxidized, and reduced forms of cysteine (P < 0.001), homocysteine (P < 0.001), and cysteinylglycine (P < 0.006) and significantly depressed levels of total and oxidized forms of glutathione (P < 0.03) and nitrite (P < 0.001) in MDS patients compared to healthy donors. Moreover, total (P < 0.032) and oxidized cysteinylglycine (P = 0.029) and nitrite (P = 0.021) differed significantly between the analyzed MDS subgroups with different clinical classifications. Malondialdehyde levels in plasma correlated moderately with both serum ferritin levels (r = 0.78, P = 0.001) and serum free iron levels (r = 0.60, P = 0.001) and were significantly higher in patients with iron overload. The other analyzed compounds lacked correlation with iron overload (represented by serum iron/ferritin levels). For the first time our results have revealed significant differences in the concentrations of plasma aminothiols in MDS patients, when compared to healthy donors. We found no correlation of these parameters with iron overload and suggest the role of oxidative stress in the development of MDS disease.
- MeSH
- dipeptidy krev MeSH
- dusičnany krev MeSH
- dusitany krev MeSH
- ferritin krev MeSH
- lidé MeSH
- malondialdehyd krev MeSH
- myelodysplastické syndromy krev komplikace patologie MeSH
- oxidace-redukce MeSH
- oxidační stres MeSH
- přetížení železem krev komplikace patologie MeSH
- studie případů a kontrol MeSH
- sulfhydrylové sloučeniny krev MeSH
- výsledek terapie MeSH
- železo krev MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Myelodysplastický syndrom je jedno z nejčastějších hematologických onemocnění ve věku nad 60 let. Donedávna byla terapie tohoto onemocnění velice svízelná a často končící jenom podpůrnou léčbou. V poslední době se objevily nové nadějné preparáty, které znamenají velký průlom nejen v terapii MDS, ale i v zájmu o patogenezi tohoto onemocnění. V naší práci se věnujeme vývoji v terapii MDS a zvláště pak novým preparátům a jejich přínosu.
Myelodysplastic syndrome is one of the most common hematology diseases in the age over the 60. Until recently the therapy of this disease was frustrating and often based only on supportive care. The last decade witnessed the emergence of promising drugs that represent a major breakthrough in the therapy and interest of decoding of the pathogenesis of this disease. In our work we summarize the evolution of MDS therapy with accent on the new drugs contribution.
- MeSH
- antimetabolity antitumorózní terapeutické užití MeSH
- azacytidin terapeutické užití MeSH
- chelátory železa terapeutické užití MeSH
- erythropoetin analogy a deriváty terapeutické užití MeSH
- ferritin krev MeSH
- imunologické faktory terapeutické užití MeSH
- imunosupresiva terapeutické užití MeSH
- krevní transfuze MeSH
- lidé MeSH
- myelodysplastické syndromy * farmakoterapie terapie MeSH
- potransfuzní reakce MeSH
- přetížení železem komplikace MeSH
- receptory thrombopoetinu agonisté terapeutické užití MeSH
- rekombinantní fúzní proteiny terapeutické užití MeSH
- thalidomid analogy a deriváty terapeutické užití MeSH
- transplantace hematopoetických kmenových buněk MeSH
- transplantace kostní dřeně MeSH
- Check Tag
- lidé MeSH
- MeSH
- Fabryho nemoc etiologie MeSH
- Gaucherova nemoc MeSH
- glykogenóza typu II MeSH
- glykogenóza typu IIb MeSH
- glykosfingolipidy genetika škodlivé účinky MeSH
- hemochromatóza komplikace MeSH
- karnitin nedostatek MeSH
- lidé MeSH
- metabolické nemoci * MeSH
- mitochondriální nemoci * komplikace MeSH
- mukopolysacharidózy komplikace MeSH
- nemoci srdce * komplikace MeSH
- přetížení železem komplikace MeSH
- Check Tag
- lidé MeSH
Myelodysplastický syndrom (MDS) je klonální onemocnění hemopoetické tkáně. Zahrnuje heterogenní skupinu onemocnění, pro něž je charakteristická diskrepance mezi bohatou krvetvorbou a periferní pancytopenií jako následek inefektivní hemopoezy s klinickými projevy anemie, infekce a krvácením.
- MeSH
- benzoáty farmakologie MeSH
- deferoxamin farmakologie MeSH
- krevní transfuze MeSH
- lidé MeSH
- myelodysplastické syndromy farmakoterapie MeSH
- potransfuzní reakce MeSH
- přetížení železem etiologie farmakoterapie komplikace MeSH
- pyridony farmakologie MeSH
- triazoly farmakologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: Iron overload and hepatitis C virus (HCV) infection are independent factors which are thought to play a role in the pathogenesis of porphyria cutanea tarda (PCT). OBJECTIVES: To determine the prevalence of the HFE gene mutations p.Cys282Tyr (C282Y), p.His63Asp (H63D) and p.Ser65Cys (S65C), the p.Tyr250X (Y250X) mutation of the TFR2 gene, and HCV infection in patients with PCT in the Czech population, and to make comparison of the iron status among the respective genotypes. METHODS: Iron metabolism indices, results of mutational analysis and serological markers of HCV infection were examined in 63 patients with PCT. RESULTS: The HFE gene mutations were detected in 70% of patients with PCT compared with 35% in the control group (P < 0.001). Mean serum ferritin levels were increased in all genotypes, the highest being in homozygotes for the p.Cys282Tyr mutation. HCV infection was detected in only 8% of patients with PCT. CONCLUSIONS: There was a very high prevalence of the p.Cys282Tyr and p.His63Asp mutations observed in patients with PCT accompanied by mild degrees of iron overload, which was genotype dependent.
- MeSH
- biologické markery krev MeSH
- chronická hepatitida C komplikace MeSH
- dospělí MeSH
- ferritin analýza MeSH
- financování organizované MeSH
- genetická predispozice k nemoci MeSH
- genotyp MeSH
- Hepacivirus MeSH
- histokompatibilita - antigeny třídy I MeSH
- homozygot MeSH
- lidé středního věku MeSH
- lidé MeSH
- membránové proteiny genetika MeSH
- mutace MeSH
- mutační analýza DNA MeSH
- porphyria cutanea tarda genetika virologie MeSH
- přetížení železem genetika komplikace MeSH
- prevalence MeSH
- rozdělení chí kvadrát MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- ateroskleróza * etiologie metabolismus MeSH
- deficit železa MeSH
- financování organizované MeSH
- hemochromatóza genetika metabolismus MeSH
- kationické antimikrobiální peptidy metabolismus účinky léků MeSH
- lidé MeSH
- metaanalýza jako téma MeSH
- peroxidace lipidů fyziologie účinky léků MeSH
- poruchy metabolismu železa * komplikace MeSH
- přetížení železem komplikace metabolismus MeSH
- reaktivní formy kyslíku metabolismus škodlivé účinky MeSH
- železo metabolismus toxicita MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH