Changes In Ferritin Concentrations Research Articles

Is Serum Ferritin a Predictor of Blood Transfusions Outcome and Survival in Childhood Lymphomas and Solid Tumors?

Packed red blood cell (PRBC) transfusions are an important part of supportive treatment in oncology; however, when used frequently, they can be a result of transfusion-related iron overload. The aim of the study was to evaluate the role of ferritin as a non-specific marker of neoplastic growth and transfusion-related iron overload in children with lymphomas and solid tumors. We performed a longitudinal analysis of PRBC transfusions and changes in ferritin concentrations during oncological treatment of 88 children with lymphomas and solid tumors. A ferritin concentration above 500 ng/mL was diagnosed in 14.77% of patients at the moment of admission and 18.18% at the end of treatment. No differences were shown in serum ferritin in the context of tumor type-, sex-, and transfusion-related parameters. Those above the age of 10 demonstrated higher ferritin concentrations compared to subjects younger than 5 years of age. In addition, those over than 10 years old or above 30 kg in weight showed a tendency for better survival. All tested patients demonstrated highly significant correlations between ferritin at the 15th month of treatment or after therapy discontinuation and transfusion-related parameters. Interestingly, ferritin levels were found to lower back to the values before therapy shortly after its discontinuation. Transfusion parameters and ferritin levels had no influence on the survival of the studied cancer patients.

Iron Overload in Children with Acute Lymphoblastic and Acute Myeloblastic Leukemia-Experience of One Center.

Transfusions of packed red blood cells (PRBCs), given due to an oncological disease and its acute complications, are an indispensable part of anticancer therapy. However, they can lead to post-transfusion iron overload. The study aim was to evaluate the role of ferritin as a nonspecific marker of leukemic growth and marker of transfusion-related iron overload. We performed a longitudinal study of PRBC transfusions and changes in ferritin concentrations during the oncological treatment of 135 patients with childhood acute lymphoblastic and acute myeloblastic leukemia (ALL and AML, median age 5.62 years). At the diagnosis, 41% of patients had a ferritin level over 500 ng/mL, and 14% of patients had a ferritin level over 1000 ng/mL. At the cessation of the treatment, 80% of the children had serum ferritin (SF) over 500 ng/mL, and 31% had SF over 1000 ng/mL. There was no significant difference between SF at the beginning of the treatment between ALL and AML patients, but children with AML finished treatment with statistically higher SF. AML patients had also statistically higher number of transfusions. We found statistically significant positive correlations between ferritin and age, and weight and units of transfused blood. Serum ferritin at the moment of diagnosis can be a useful marker of leukemic growth, but high levels of SF are connected with iron overload in both AML and ALL.

БІОХІМІЧНІ ПОКАЗНИКИ КРОВІ У ХВОРИХ НА РОЗСІЯНИЙ СКЛЕРОЗ, ЯКІ ПЕРЕНЕСЛИ ІНФЕКЦІЮ SARS-CoV-2

B a c k g r o u n d. Currently, multiple sclerosis (MS) is an important medical and social problem. There are already more than 2.8 million people with MS worldwide, and due to the lack of effective methods of treatment and prevention, the number of patients is increasing constantly. Therefore, the search for new ways and approaches aimed towards stabilizing the patient's condition is a priority task of modern neurobiology. It is also important to identify triggers that can lead to accelerating the rate of disease progression. Since MS is an immune-mediated disorder, we hypothesized that concomitant diseases of infectious etiology, via the activation of an inflammatory reactions cascade, can lead to a worsening of the MS patient's condition. However, the final answer to the question of whether acute viral infections affect the condition of patients with MS has not been obtained yet. In the context of the epidemiological situation that has developed in recent years, due to the spread of the SARS-CoV-2 coronavirus infection, it is interesting to study the possible negative consequences of COVID-19 in people suffering from MS. The aim of the study was to analyze the general biochemical status of patients with MS who had or did not have a confirmed history of COVID-19. M e t h o d s. A total of 271 participants were enrolled in this study, including 97 MS patients and 30 healthy volunteers who matched for age and sex. Patients with MS were divided into two groups: group I (n= 56; 36 women and 20 men, average age: 41.3±5.5, disease duration: 4.4±1.5 years) – patients with MS who did not have confirmed history of COVID-19 and group II (n= 41; 27 women and 14 men, average age: 40.2±5.6, disease duration: 4.6±1.3 years) – patients with MS, who had a laboratory-verified diagnosis of COVID-19 in the past 4-7 months. Blood serum samples of patients and healthy donors were obtained from the University Clinic of O.O. Bogomolets National Medical University, Kyiv, Ukraine. All patients were diagnosed with MS according to the 2017 McDonald criteria. R e s u l t s. It was established that both groups of MS patients had similar changes in blood biochemical parameters compared to the healthy indicators: a decrease in creatinine and uric acid concentrations; decrease in the levels of particular lipid fractions, namely VLDL and TAG; decrease in the activities of AP and LDH; increase in C-reactive protein concentration. The only significant differences between groups I and II were noted due to multidirectional changes in serum ferritin concentration and an increase in the level of amylase activity in the blood serum of patients with MS in post- COVID period. C o n c l u s i o n s. The absence of statistically significant differences between the blood biochemical parameters in patients with MS who had or did not have confirmed history of COVID-19 indicates the absence of a relationship between SARS-CoV-2 infection and changes of particular studied parameters. Among the results obtained, the multidirectional changes in ferritin concentration in MS patients before and after COVID-19 could be of great interest to further research.

Capillary Blood Recovery Variables in Young Swimmers: An Observational Case Study.

Sport diagnostics is still in pursuit of the optimal combination of biochemical and hematological markers to assess training loads and the effectiveness of recovery. The biochemical and hematological markers selected for a panel should be specific to the sport and training program. Therefore, the aim of this study was to evaluate the usefulness of selected biochemical and hematological variables in professional long-distance and sprint swimming. Twenty-seven participants aged 15–18 years took part in the study. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) activities and creatinine (Cr), C-reactive protein (CRP), ferritin, total bilirubin (TB), direct bilirubin (DB) and iron concentrations were measured for 10 weeks and compared with the traditional sport diagnostic markers of creatine kinase (CK) activity and urea (U) concentration. Additionally, capillary blood morphology was analyzed. An effective panel should consist of measurements of CK and AST activities and urea, TB, DB and ferritin concentrations. These markers provide a good overview of athletes’ post-training effort changes, can help assess the effectiveness of their recovery regardless of sex or competitive distance and are affordable. Moreover, changes in ferritin concentration can indicate inflammation status and, when combined with iron concentration and blood morphology, can help to avoid iron deficiencies, anemia and adverse inflammatory states in swimmers.

Differential Degradation of Ferritin H- and L-Chains: Accumulation of L-Chain-Rich Ferritin in Lens Epithelial Cells

The storage of iron by ferritin is determined by tissue-specific composition of its 24 subunits, which are designated as either heavy (H) or light (L). For a better understanding of how lens epithelial cells regulate their ferritin subunit makeup, the degradation pattern of each subunit type was analyzed. In addition, age-related changes in ferritin concentration and subunit makeup were determined. Ferritin turnover in primary cultures of canine lens epithelial cells was determined by metabolic labeling with [(35)S]-methionine. Transient transfection with vectors containing coding sequences for either H- or L-chains were used to modify ferritin subunit makeup. Ferritin concentration was measured by ELISA. Immunodetection and fluorescence immunocytochemistry were used to study age-related changes in ferritin chain concentration. Inhibition of the proteasomal protein degradation pathway by clastolactacystin-beta-lactone had no effect on ferritin degradation, whereas inhibition of lysosomal degradation markedly increased ferritin levels, confirming that this system is involved in ferritin turnover. H-chain ferritin degraded at a faster rate than the L-chain. L-chain-rich ferritin in L-chain-transfected cells formed inclusion bodies that were localized to the cytosol. Similar inclusion bodies were found in older lens cells kept in cell culture for more than 8 days. Steady degradation of H-chain ferritin contributed to the maintenance of a constant level of this chain within the lens epithelial cells. In contrast, slower turnover of the L-chain resulted in accumulation of L-chain-enriched ferritin associated with cytoplasmic inclusion bodies. These L-chain-containing inclusion bodies were found in the cytosol of cells overexpressing L-ferritin chain and in nontransfected cells maintained in culture for 8 to 35 days. Overexpression of the L-chain has been associated with the formation of premature cataracts in humans with hereditary hyperferritinemia cataract syndrome. The formation of inclusion bodies in older lens epithelial cells, as demonstrated in the current investigation, is intriguing and could point to possible involvement of cytoplasmic L-chain-enriched ferritin aggregates in the formation of age-related cataract.

Effects of the Zanzibar school-based deworming program on iron status of children

We evaluated the effects of the Zanzibar school-based deworming program on the iron status of primary school children. Parasitologic and nutritional assessments were carried out at baseline, 6 mo, and 12 mo in 4 nonprogram schools (n = 1002), 4 schools in which students received twice-yearly deworming (n = 952), and 4 schools in which students received thrice-yearly deworming (n = 970) with 500 mg generic mebendazole. Schools were randomly selected for evaluation and allocated to program groups. Relative to no treatment, thrice-yearly deworming caused significant decreases in protoporphyrin concentrations and both deworming regimens caused marginally significant increases in serum ferritin concentrations. The average annual changes in protoporphyrin concentrations were -5.9 and -23.5 μmol/mol heme in the control and thrice-yearly deworming groups, respectively (P < 0.001). The average changes in ferritin concentration were 2.8 and 4.5 μg/L, respectively (P = 0.07). Deworming had no effect on annual hemoglobin change or prevalence of anemia. However, the relative risk of severe anemia (hemoglobin < 70 g/L) was 0.77 (95% confidence limits: 0.39, 1.51) in the twice-yearly deworming group and 0.45 (0.19, 1.08) in the thrice-yearly deworming group. The effects on prevalence of high protoporphyrin values and incidence of moderate-to-severe anemia (hemoglobin < 90 g/L) were significantly greater in children with > 2000 hookworm eggs/g feces at baseline. We estimate that this deworming program prevented 1260 cases of moderate-to-severe anemia and 276 cases of severe anemia in a population of 30,000 schoolchildren in 1 y. Where hookworm is heavily endemic, deworming programs can improve iron status and prevent moderate and severe anemia, but deworming may be needed at least twice yearly. Am J Clin Nutr 1998;68:179–86.

Measurements of serum ferritin used to predict concentrations of iron in bone marrow in anemia of chronic disease

We determined serum ferritin, C-reactive protein (CRP), fibrinogen, and the erythrocyte sedimentation rate (ESR) in 73 patients with anemia of chronic disease. Nomograms of CRP, ESR, or fibrinogen vs ferritin concentrations were constructed and used to estimate the iron store in bone marrow. Iron stores estimated from the nomograms were compared with the results of staining cytological bone marrow smears for iron, the reference method for evaluating iron in bone marrow. In contrast to the results of Witte et al. (Clin Chem 1985;31:1011; Am J Clin Pathol 1986;85:202-6 and 1988;90:85-7), we observed that nomograms of CRP, fibrinogen, or ESR (i.e., acute-phase reactants not influenced by changes in iron metabolism) vs ferritin are not suitable to correct for the acute-phase component of changes in ferritin concentrations. For ferritin concentrations less than 70 micrograms/L, we found that iron deficiency, as judged from bone marrow iron stain, apparently was always present.