Hematological Pattern Research Articles

Insights into Hemoglobin Polymorphism and Related Functional Effects on Hematological Pattern in Mediterranean Cattle, Goat and Sheep

This report is a review of some of the results obtained over the course of 20 years spent investigating hemoglobin phenotypes and the related functional effects on hematological patterns in ruminant breeds. Tests included qualitative and quantitative analyses of hemoglobins and qualitative and quantitative analyses of α and β globins, as well as hemochromocytometric analysis. Understanding the adaptive significance of the hemoglobin variants was the goal of most of these investigations. The advances presented in this review and the previously unpublished findings included here provide evidence that Mediterranean breeds exhibit a fair number of positively charged variants, whose possible adaptive significance is discussed.

The SARS outbreak in a general hospital in Tianjin, China: clinical aspects and risk factors for disease outcome

To describe clinical characteristics of severe acute respiratory syndrome (SARS) patients in a hospital in Tianjin, China, thereby comparing probable and suspected cases; to study risk factors associated with the death of cases; to describe the implementation of preventive interventions during the hospital outbreak. Physical and haematological information was obtained from clinical records. White blood cell counts, and percentages of neutrophilic granulocytes and neutrophilic lymphocytes were measured. The service department of the hospital provided information about daily use of protective materials. Differences in clinical symptoms between probable and suspected SARS cases were tested by Fisher's exact test. Non-linear mixed modelling was used to test for differences between the haematological patterns for probable and suspected cases. Risk factors for dying among probable SARS cases were tested by logistic regression. The SARS outbreak started with a patient from Beijing on 15 April 2003, and spread quickly among the healthcare workers and in-patients in the hospital. In total 90 probable and 21 suspected cases were reported, with 17 deaths among them (case fatality rate 15%). Haematological patterns were significantly different between probable and suspected cases, whereas the percentages with certain clinical symptoms showed no apparent difference. Death of probable SARS cases was only significantly associated with high age and use of a respiratory machine (mainly for the most severe cases), whereas e.g. co-morbidity and steroid treatment showed no impact in multivariate analysis. Stringent control measures, including distribution of huge numbers of protective materials, started on 20 April, which soon lead to a strong decrease in the incidence of new cases. After the last SARS case left the hospital on 6 June, protective materials were dispensed at substantially lower rates, but not to zero, as was the case during the first days of the outbreak. The working definition of probable SARS used during the epidemic appeared to have been fairly accurate. Many valuable lessons were learned regarding prevention of hospital spread of infection, especially the need to have sufficient protective supplies available and to implement these rigidly and at an early stage of an (threatening) epidemic.

Association of Hematological Parameters with Insulin Resistance and β-Cell Dysfunction in Nondiabetic Subjects

Previous studies reported independent associations of hematological parameters with risk of incident type 2 diabetes, although limited data are available on associations of these parameters with insulin resistance (IR) and (especially) pancreatic beta-cell dysfunction in large epidemiological studies. Our objective was to evaluate the associations of hematological parameters, including hematocrit (HCT), hemoglobin (Hgb), red blood cell count (RBC), and white blood cell count with IR and beta-cell dysfunction in a cohort of nondiabetic subjects at high metabolic risk. Nondiabetic subjects (n = 712) were recruited in Toronto and London, Ontario, Canada, between 2004 and 2006, based on the presence of one or more risk factors for type 2 diabetes mellitus including obesity, hypertension, a family history of diabetes, and/or a history of gestational diabetes. Fasting blood samples were collected and oral glucose tolerance tests administered, with additional samples for glucose and insulin drawn at 30 and 120 min. Measures of IR included the homeostasis model assessment (HOMA-IR) and Matsuda's insulin sensitivity index, whereas measures of beta-cell dysfunction included the insulinogenic index divided by HOMA-IR as well as the insulin secretion-sensitivity index-2. Associations of hematological parameters with IR and beta-cell dysfunction were assessed using multiple linear regression and analysis of covariance with adjustments for age, gender, ethnicity, smoking, cardiovascular disease, systolic and diastolic blood pressure, and waist circumference. HOMA-IR increased across quartiles of HCT, Hgb, RBC, and white blood cell count after adjustment for age, gender, ethnicity, and smoking (all P (trend) <0.0001). Similarly, there was a strong stepwise decrease in the Matsuda's insulin sensitivity index across increasing quartiles of these hematological measures (all P (trend) <0.0001). The associations remained significant after further adjustment for previous cardiovascular disease, blood pressure, and waist circumference (all P (trend) <0.0001). Similarly, there was a strong pattern of decreasing beta-cell function across increasing quartiles of all hematological patterns (all P (trend) <0.0001). The findings for HCT, Hgb, and RBC were attenuated slightly after full multivariate adjustment, although the trend across quartiles remained highly significant. These findings suggest that standard, clinically relevant hematological variables may be related to the underlying pathophysiological changes associated with type 2 diabetes mellitus.

Parámetros hematológicos de pacientes con fibrosis 2133quística de la costa caribe colombiana: análisis y asociación con aislamiento de pseudomonasaeruginosa

El hemograma es una herramienta fundamental en el control de pacientes con fibrosis quística porque múltiples factores podrían alterar sus parámetros. El objetivo de éste estudio fue analizar y describir los parámetros hematológicos de pacientes con fibrosis quística y determinar su asociación con la infección causada por Pseudomonas aeruginosa y administración de micronutrientes. A 19 pacientes con historia clínica de fibrosis quística se les realizó un hemograma convencional, cultivo de esputo y examen físico.Siete pacientes (36,8%) presentaron anemia, fue sintomática en un solo caso y leve en los demás. Cuatro pacientes (21%) recibían inadecuada administración de micronutrientes. No hubo asociación significativa entre la presencia de anemia y el régimen de administración de micronutrientes con RR 0,63 IC 95% (0,18–3,81). Cuatro (21%) presentaron leucocitosis, dos (10,5%) presentaron eosinofilía.Se aisló Pseudomonas aeruginosa en 8 pacientes (42%), encontrándose una asociación significativa entre anemia e infección causada por este patógeno, con un RR de 8,25 IC 95% (1,22–12,06), no siendo significativa la relación entre ésta y los valores de leucocitos. La prevalencia de anemia, probablemente de clase ferropénica, fue mayor que la reportada en la literatura y puede relacionarse quizás con la infección por Pseudomonas aeruginosa, mientras que la administración de micronutrientes posiblemente no se relaciona. La administración crónica de medicamentos puede ser uno de los factores importantes que influyan en los parámetros hematológicos.

Relative dose intensity reduction in breast cancer adjuvant chemotherapy.

Abstract Abstract #4111 Introduction&amp;#x2028; In breast cancer (BC), adjuvant chemotherapy has become a standard therapy, resulting in prolonged survival. This goal might be affected by chemotherapy dose reductions and delays that are not uncommon features.&amp;#x2028; The aim of this study was to assess relative dose intensity (RDI) reduction risk factors and define predictive factors.&amp;#x2028; Methods&amp;#x2028; Data regarding BC patients (pts) under anthracycline based-chemotherapy regimens was collected, retrospectively, from two Portuguese centres, between 1998 and 2007, and combined into a database of 783 individuals. Primary G-CSF prophylaxis was not planned. DIEP® (Dose Intensity Evaluation Programme) software was developed to allow calculation of RDI, and includes demographic data, clinical and treatment characteristics, chemotherapy dose modifications and delays, haematological toxicities and patterns of use of G-CSF.&amp;#x2028; Univariate and multivariate analysis was performed to identify factors related to RDI ≤ 90% in these patients. A value of P &amp;lt; 0.05 was considered of statistical significance.&amp;#x2028; Results&amp;#x2028; Pts distribution according to chemotherapy: doxorubicin/cyclophosphamide (A60 C600) – 31,5%, 5-fluorouracil/epirubicin/cyclophosphamide (F500 E100 C500) – 19,2%, 5-fluorouracil/doxorubicin/cyclophosphamide (F500 A50 C500) – 49,3%. A RDI ≤ 90% was frequent across all chemotherapy regimens, but most common in pts receiving FEC (34,7%) and AC (23,5%) regimens.&amp;#x2028; According to univariate analysis, factors related to reduction of RDI were: age ≥ 65 years (P = 0,006), node positive (P = 0,037), chemotherapy regimen (P &amp;lt; 0,001), number of pts with at least one G-CSF administration on secondary prophylaxis (P = 0,015), number of pts with at least one G-CSF administration due to neutropenia or febrile neutropenia (P &amp;lt; 0,001 ) and number of pts with at least one hospitalization due to febrile neutropenia (P &amp;lt; 0.001). In multivariate analysis, independent predictors of RDI ≤ 90% were: AC regimen (P = 0,008), FEC regimen (P = 0,002), age ≥ 65 years old (P = 0,018), node positive (P = 0,016) and at least one hospitalization due to febrile neutropenia (P &amp;lt; 0,001).&amp;#x2028; Conclusion&amp;#x2028; A considerable number of our BC pts, submitted to anthracycline based-chemotherapy, continue to experience RDI reductions. Most affected pts were more than 65 years old, or under FEC or AC regimens, or had node positive tumors. This data might help to identify a subgroup of BC pts that benefit from primary prophylaxis with G-CSF. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4111.

CONTRIBUIÇÃO AO ESTUDO DO QUADRO SANGÜÍNEO PARA DETERMINAR OS VALORES HEMATOLÓGICOS NORMAIS EM EQÜINOS DA RAÇA MANGALARGA

The hematological parameters estimation was carried out in 15 Mangalarga horses, kept in pasture during the months of January, February, May and June of 1990 and 1991. The results indicated that the hematological pattern is normal for the specie. KEY-WORDS: Equine; hematology; teaser.

Haematological Changes in Tuberculosis in Kano, Nigeria

The potential hazard associated with the concentration processes of sputum for acid fast bacilli (AFB) and lack of culture facilities have made it inevitable for many centers which rely on direct sputum smear microscopy to under-diagnose tuberculosis. This is the situation in Kano metropolis where the prevalence rate may be difficult to determine. The aim of this study is to establish a characteristic haematological pattern which could assist in the differential diagnosis of tuberculosis. Routine haematological analysis was carried out in respect of PCV, Hb, WBC (Total and differential counts), erythrocyte sedimentation rate (ESR) and blood film examination in 290 AFB positive patients who attended the General Outpatients Departments of Infectious Diseases Hospital and Aminu Kano Teaching Hospital Kano, between April 2001 and December 2004. Age- and sex-matched healthy controls were evaluated along with the enrolled patients. The highest prevalence rate of infection 90 (31%) occurred in the age groups (21 – 30 years). In patients with pulmonary tuberculosis, the prevalence of mild anemia, raised ESR, leucocytosis, neutrophilia with toxic granulations, thrombocytosis and occasional stickiness of platelets, and monocytosis was higher (P Keywords : Haematology, tuberculosis, Kano. Journal of Medical Laboratory Sciences Vol. 14 (2) 2005: pp. 35-39

Multivariate dimensions of hemotologic chaos indices for responders versus non-responders of patients with myelodysplastic syndromes (MDS) after treatment with ptx/cipro/decadron: A qualitative study

17540 Background: In our clinical study of 35 MDS patients who were treated with PTX/Cipro/Decadron, there was an 80% response rate in terms of achieving improved hematopoiesis (responders) during a 4-week period. The primary question of interest was, “What were the hematologic dynamic patterns that transpired between patients who responded versus those who did not?” The purpose of this study was an attempt to answer this question by applying chaos theory to peruse the underlying patterns that may have prognosis utility. Methods: Responders and non-responders were identified and were matched by age, sex, and FAB type. Only those patients who have sufficient and complete hematologic evaluations after treatment with at least 6 months follow-up to derive stable chaotic indices were included. The resulted sample was 3 patients from the non-responded group and 4 patients from the responded group. The three selected hematoloic parametes were white blood count, hemoglobin and platelets. The selected chaos index to indicate its magnitude of across time was the fractal dimension that has three components, namely capacity, information and correlational. Results: The mean ages for the non-responders and responders were 68 and 65, respectively. The median number of weeks evaluated was 38 for the non-responders and 35 weeks for the responders. The three hematologic parameters were analyzed simultaneously in the form of 3-dimensional space. Table indicates the chaos fractal indices for the two groups. Conclusion: Across the three indices, non-responders have an average of 7.4 % larger than responders, suggesting the former exhibited a relatively higher degree of “chaos” than the latter. For prognosis purpose, this result also suggests that patients who exhibit lower magnitude of the chaotic phenomena, will have a higher probability of responding to therapy. This work was done while the authors were at Rush-Presbyterian-St.Luke’s Medical Center. [Table: see text] No significant financial relationships to disclose.

Functional effect of haemoglobin polymorphism on the haematological pattern of Gentile di Puglia sheep

The relationship between haemoglobin polymorphism and haematological pattern were studied in Gentile di Puglia, the Apulia Merino native breed. In a sample of 292 individuals, on five different farms, alpha- and beta-globin genetic polymorphism was investigated. A remarkable polymorphism was detected especially at alpha-globin gene where the variations concerned both the quality of the gene product and gene expression. Triplicated and quadruplicated alpha-globin genes were observed in 8.6% and 1.2% of the alpha-haplotypes respectively. At beta-globin (HBB) locus, predominance of HBB(B) allele was found in all flocks, while HBB(A) overall frequency was around 11.2%. Moreover, the effect of genotypes at globin systems on haematological data was evaluated on 289 animals. A significant effect was detected for HBB locus on haematocrit (HCT) and mean corpuscular volume (MCV), with decreasing HCT and MCV for decreasing number of HBB(A) alleles in the genotype. The opposite trend was observed for mean corpuscular haemoglobin concentration. The advances presented by this paper give reasons for inferring that BB genotypes can be expected to be more resilient to climatic stress and to local parasites.

Effects of cadmium and nickel exposure on haematological parameters of common carp, Cyprinus carpio L.

Introduction. Single intraperitoneal injections of sublethal doses of cadmium (10&nbsp;&micro;g&nbsp;Cd&#183;kg-1 body weight) and nickel (60 &micro;g Cd&#183;kg-1 body weight) were administered to carp, Cyprinus carpio L., to determine detoxification potential of the fish affected after transfer to a clean milieu, as revealed by haematological parameters. Observation of haematological parameters allows the most rapid detection of changes in fish after cadmium and nickel injection Disrupted haematological patterns appear very quickly and precede changes in fish behaviour and visible lesions. The rapidity of toxic effects exerted by xenobiotics is related to the blood&#8217;s transport function, with the blood distributing the metals to all the body parts. Materials and methods. Each experiment took 60 days and was divided into 8 stages during which blood was collected for assays. At each stage, blood samples were assayed for selected haematological parameters (RBC, WBC, Hb, Hct, MCV, MCHC, MCH). Results. Cadmium and nickel exposure-related changes in haematological parameters were detected. Immediately after injection, the haematological parameters were seen to change, a return to the normal values being observed after some time. The study allowed following the changes in the haematological parameters of cadmium- and nickel-injected carp during the process ofdetoxification. Conclusion. Within the 60 days following injection of sublethal doses of cadmium and nickel, haematological parameters were observed to revert to the levels close to those in the control.

Impact of hemoglobin levels in psychiatric patients with cancer

8233 Background: previously, we reported toxicity in a series of 26 psychiatric patients with cancer that underwent to chemotherapy (De Marino et al.; Proc. ASCO 2003). Updating our data on 27 patients,13 with haematological (H) and 14 with solid (S) tumour we observed heavy psychotic episodes in 10/27(37%)during treatments. In order to assess associations among chemotherapy related toxicities and attacks we performed the following analysis. Methods: the records of 10 patients with psychotic acute episodes were reviewed retrospectively with regards histology, sex, age, mental disorders according to standard psychiatric Diagnostic and Statistical Manual (DSM IV), haematological pattern, uprising modality and length of attacks, treatment changes. Results: Of the 10 patients, median age 69 years (range 38–85),8 males and 2 females, 7/10(70%) H: 3 Non Hodgkin's disease, 2 Multiple Myeloma,1 Myelodysplasia and 1 Chronic Myeloid Leukemia while 3/10(30%) S:2 breast,1 lung. Mental disorders were: 4 organic psychosis and dementia (F 00.10); 2 heavy recurrent depression (F.33); 3 schizophrenia (F.20); 1 personality disorder (F.21); 1 adjustment disorders (F 43.20). In 8/10(80%) patients, psychotic episodes occurred during chemotherapy (7/8 at nadir and 1/8 during bleeding) but in 2/10 patients not (progressive disease). Haematological toxicity was: neutropenia G3 in 5/10(50%), anaemia G2–3 in 10/10(100%). All were outpatients and had recovery in isolation ward during psychotic episodes and received sedatives by psychiatrist. Psychotic episodes were transient (< 3 days), became evident together with anemia (HB<9 g/dL), disappeared when haemoglobin reached at least 9.4g/dL thanks to blood transfusions. No lasting changes in psychiatric treatment were made. Conclusions: our preliminary experience indicates the possible interplay between anemia and psychotic episodes in patients with mayor mental disorders and malignancy, especially H. More patients are needed to confirm potential utility of this observation to classify correctly according to current nosologic multiaxial system. No significant financial relationships to disclose.

Primary Sjögren syndrome: hematologic patterns of disease expression.

Primary Sjögren syndrome: hematologic patterns of disease expression.

Blood cells of sea bass (Dicentrarchus labrax L.). Flow cytometric and microscopic studies.

Studies of fish blood cells made to date presented numerous problems derived from both the nomenclature and the techniques used. A combination of quantitative and morphological methods is needed if the classification of fish blood cells is to advance from it present provisional state. The aim of the present paper was first to isolate sea bass blood cell populations by flow cytometry and second to characterize then microscopically. Blood cell populations from sea bass (Dicentrarchus labrax L.) were isolated according to their FSC (size) and SSC (granularity) properties by flow cytometry. The isolated populations were then processed for light and transmission and scanning electron microscopic characterization. Sea bass blood leukocytes isolated by flow cytometry consisted of two main cell subpopulations. Subsequent microscopic study of these cells revealed that the first subpopulation was composed of small cells (3-5 microm) of low granularity and consisted of thrombocytes and lymphocytes whereas, the second subpopulation was formed of 6-9 microm sized cells of high granularity consisting of granulocytes and monocyte/macrophages. The combined use of flow cytometry and electron microscopy makes it possible to characterize the different cell types present in sea bass peripheral blood with a high degree of certainty. Although sea bass basically follows the common vertebrate hematological pattern, significant modifications such as the presence of circulating immature erythrocytes, plasma cells and monocyte/macrophages and different forms of thrombocytes can be established with respect to this pattern.

Haematological Parameters and Altered Erythrocyte Metabolism in Anaemic Dogs

In previous studies, an increase in the activity of pyruvate kinase (PK) and glucose-6-phosphate dehydrogenase (G6PDH), an increase in the concentration of 2,3-diphosphoglycerate (2,3DPG), and alterations in osmotic fragility were found in dogs with haemolytic anaemia. These changes were mainly caused by the presence of immature red cells found in regenerative anaemias. In the present study, the same parameters were evaluated in dogs with different types of anaemia. The haematological patterns of 40 anaemic dogs were analysed to define the pathogenesis and the haematological features of each case. Non-regenerative anaemias could be attributed principally to chronic diseases and to the haemolysis that accompanies the early stages of canine babesiosis. Regenerative anaemias were mainly due to haemolysis, in some cases with an immune-mediated pathogenesis. PK activity was higher in regenerative than in non-regenerative anaemias, but G6PDH activity and 2,3DPG concentration increased in both types of anaemia. This suggests that PK activity is influenced by the presence of immature red cells, but the requirements for reducing compounds and oxygen are not dependent on the type of anaemia. Abnormalities in osmotic fragility were detected in haemolytic anaemias and in those non-regenerative anaemias in which reticulocyte percentage, but not reticulocyte production index (RPI), increased. The osmotic fragility could be used as an early indicator of erythrocyte regeneration.

Interferon-alpha inhibits CFU-GM mobilization following chemotherapy and G-CSF administration.

Changes in routine hematologic data and in circulating granulocyte-macrophage colony-forming units (CFU-GM) during granulocyte colony-stimulating factor (G-CSF) administration were evaluated in non-small cell lung carcinoma (NSCLC) patients treated with a combination of 5-fluorouracil (5-FU) and cisplatin (DDP) with and without the addition of interferon-alpha (IFN-alpha). The patterns of leukocyte changes following chemotherapy plus G-CSF were similar in both the IFN-alpha-inclusive and the IFN-alpha-devoid courses. However, the twofold increase in CFU-GM observed in patients receiving chemotherapy plus G-CSF was completely absent following the course including IFN-alpha. The activity of G-CSF on the hematologic pattern is seemingly affected by its combination with IFN-alpha treatment. Mechanisms of the possible in vivo interaction among IFNs and hematopoietic growth factors remain to be elucidated.

Lymphoid blast crisis at the onset of chronic myelogenous leukaemia: molecular evidence

A patient with a typical haematological pattern of acute lymphoblastic leukaemia with BCR and IgH rearrangements was brought into complete remission by treatment. A few weeks later she developed the typical peripheral and bone marrow pattern of chronic myelogenous leukaemia (CML) with persistence of the BCR rearrangement and disappearance of the IgH rearrangement, suggesting that this case is an example of CML presenting in blast crisis without a detectable chronic phase.

Blood cells of the gilthead seabream (Sparus aurata L.): light and electron microscopic studies.

The peripheral blood cells of the gilthead seabream (Sparus aurata L.) were studied by light and transmission and scanning electron microscopic methods. Acidophilic erythroblasts and mature erythrocytes, round, oval, and fusiform thrombocytes, neutrophils, acidophils and basophils, lymphocytes, plasma cells, and monocyte-macrophages were characterized. A comparison of our light and electron microscopic results was carried out. The results were discussed with those for other fish species and the main modifications from the common vertebrate haematological pattern observed being considered.

Autotransfusion in urology: Control study on 59 cases

We studied the hematologic and clinical patterns of 59 patients undergoing urologic surgery who entered in a predeposit autologous blood transfusion program and of 59 controls to evaluate the feasibility and safety of the autotransfusional procedure in Urology. 174 units of autologous blood were donated (average 2.94 per pt.) with a high frequency of donation (2.6 days). No side effect or alteration of performance status was reported. We had a dramatic reduction of the need for homologous blood (2.21 units per pt.) without a significant difference of the average hemoglobin concentration between the two groups at discharge from hospital. Autotransfusion has significant advantages compared with conventional transfusion, reducing the complications correlated with homologous blood infusion as also our study demonstrated. Infact 1 post-transfusional hepatitis and 3 complications due to an alteration of coagulation were reported in the control group. The procedure resulted safe and feasible in most urologic operations that require almost two units of blood transfusion.

Management of fetal hemolytic disease by cordocentesis: I. Prediction of fetal anemia

Between January 1985 and November 1990, 128 pregnancies complicated by maternal red blood cell alloimmunization were referred to our Fetal Diagnosis and Treatment Unit. We examined the premise that an evaluation of fetal blood would accurately identify fetuses at risk of requiring antenatal transfusion therapy. Two hundred seventy-two diagnostic cordocenteses were performed. Criteria for the timing of repeat cordocenteses were developed retrospectively on the basis of the fetal hematocrit values, reticulocyte counts, and direct Coombs' test results of the first 84 pregnancies. These criteria were tested and confirmed prospectively on the next 44 pregnancies. On the basis of the first blood sample, four hematologic patterns (and their distributions) were identified in the 98 antigen-positive fetuses. Pattern 1: fetuses at low risk of having significant antenatal anemia (hematocrit &#x0026;#x0026;#x003C;30%) (n = 11,11 %). These fetuses had normal hematocrit values and reticulocyte counts coupled with negative or trace-positive direct Coombs' test. No fetus in this group had significant antenatal' anemia. Pattern 2: fetuses at intermediate risk of having anemia (n = 29, 31 %). Pattern 2 fetuses had normal hematocrit values and either direct Coombs' titers of more than trace ≤2+ and normal reticulocyte counts or low reticulocyte counts (<2.5th percentile for gestation). Twenty-one percent (n = '6) of fetuses in pattern 2 had significant antenatal anemia. Patterns 3 and 4: fetuses at greatest risk of having severe anemia. These fetuses had normal hematocrit values associated with either reticulocyte counts >97.5th percentile for gestation or a direct Coombs' test ≥3+ (pattern 3, n = 49, 50%) or both, or a mild anemia (>30% but <2.5th percentile for gestation) (pattern 4, n = 9, 10%). Eighty percent (n = 39) of fetuses with pattern 3 and 90% (n = 8) with pattern 4 developed a hematocrit value <30%. We conclude that evaluation of fetal hemolytic disease with a fetal blood specimen permits the identification,of fetuses at high risk of having antenatal anemia.

Iron Uptake in Aluminium Overload: In Vivo and In Vitro Studies

In this study we have evaluated the haematological consequences of chronic aluminium (Al) overload. We have also investigated 'in vivo' whether aluminium overload may modulate gastrointestinal iron (Fe) absorption and 'in vitro' whether the presence of aluminium may influence the cellular uptake of iron. The in vivo studies were performed in rats with normal renal function and the in vitro experiments were done using the rat intestinal epithelial cell line RIE-1. The results demonstrate that aluminium deposit in tissues even with normal renal function. The intraperitoneal aluminium loading resulted in serum and tissue aluminium increases comparable with concentrations found in aluminium-intoxicated renal patients. The aluminium intoxication was accompanied by a microcytic anaemia with a haematological pattern similar to that observed in iron-deficiency anaemia. Nevertheless, iron absorption was significantly reduced despite an increased total iron binding capacity (TIBC). In addition, aluminium was also able to reduce in vitro cellular uptake of iron in the RIE-1 intestinal cell line. These experimental results demonstrate that aluminium interferes with iron absorption and iron transfer, and suggest that these mechanisms may be responsible for maintaining and even increasing the anaemia observed in aluminium overload.