Red Blood Cell Synthesis Research Articles

Seaweed a Superfood: a Nutrient-Rich Solution for Modern Diets

Seaweeds, also called macroalgae, are an abundant renewable resource that flourishes on India's northwest and southeast coasts. They create bioactive chemicals with a wide range of health benefits while thriving in a variety of harsh settings. Seaweeds supply vital materials, including agar, alginate, and carrageenan, and are widely used in industries for their gelling, stabilizing, and thickening capabilities. These are essential in the food, pharmaceutical, and other industries. Seaweed's rich nutritional profile is one of its main health advantages, particularly when it comes to treating vitamin B12 deficits, which are prevalent in pregnant women, the elderly, and vegetarians. Active vitamin B12, which is essential for many body processes, including the synthesis of red blood cells and neurological function, is known to be present in several seaweed species, such as purple laver. Seaweeds are rich in essential nutrients like proteins, amino acids, polyunsaturated fatty acids, vitamins, minerals, and polyphenols, all of which contribute to overall health. They provide essential amino acids, beneficial fatty acids for cardiovascular and brain health, and important minerals like iodine, calcium, iron, and magnesium for thyroid health and general well-being. The polysaccharides in seaweed, such as alginate and carrageenan, offer functional benefits, while their polyphenols provide antioxidant and anti-inflammatory properties. Despite these health benefits, seaweeds are underutilized in the food industry. Fortifying products like crackers and biscuits with seaweed could help address nutritional deficiencies, especially vitamin B12. Overall, seaweed has great potential as a sustainable food source that can improve nutrition and prevent diseases.

Comparative analysis of dietary iron deprivation and supplementation in a murine model of colitis.

Inflammatory bowel diseases are chronic inflammatory conditions with growing prevalence in western populations. Iron is an essential component of erythrocytes hemoglobin. Under the influence of elevated hepcidin production, iron is sequestered in cells during inflammation which, in turn, leads to iron restriction for red blood cell synthesis. As a consequence, iron deficiency and anemia of inflammation are the most prevalent extraintestinal complications in IBD patients. Iron deficiency is commonly treated with oral iron supplements, with limited efficacy as iron absorption is blunted during intestinal inflammation. Moreover, iron supplementation can cause intestinal complications, as previous studies have shown that it can worsen the inflammatory response. However, a comparative analysis of the effects of low, adequate, and high dietary iron content matching the iron supplementation given to patients has not been performed in mice. We therefore tested the impact of dietary iron deprivation and supplementation in a murine model of colitis induced by dextran sodium sulfate. We found that both dietary iron deprivation and supplementation were accompanied by a more severe inflammation with earlier signs of gastrointestinal bleeding compared to mice fed an iron-adequate diet. The manipulation of dietary iron led to a profound dysbiosis in the colon of control mice that differed depending on the dietary iron content. Analysis of this dysbiosis is in line with a pronounced susceptibility to colonic inflammation, thus questioning the benefit/risk balance of oral iron supplementation for IBD patients.

In vitro erythropoiesis: the emerging potential of induced pluripotent stem cells (iPSCs).

Due to global blood shortages and restricted donor blood storage, the focus has switched to the in vitro synthesis of red blood cells (RBCs) from induced pluripotent stem cells (iPSCs) as a potential solution. Many processes are required to synthesize RBCs from iPSCs, including the production of iPSCs from human or animal cells, differentiation of iPSCs into hematopoietic stem cells, culturing, and maturation of the hematopoietic stem cells (HSC) to make functional erythrocytes. Previous investigations on the in vitro production of erythrocytes have shown conflicting results. Some studies have demonstrated substantial yields of functional erythrocytes, whereas others have observed low yields of enucleated cells. Before large-scale in vitro RBC production can be achieved, several challenges which have limited its application in the clinic must be overcome. These issues include optimizing differentiation techniques to manufacture vast amounts of functional RBCs, upscaling the manufacturing process, cost-effectiveness, and assuring the production of RBCs with good manufacturing practices (GMP) before they can be used for therapeutic purposes.

Serum levels of copper and zinc and their relationship with iron status in sickle cell anemia patients

Purpose: To determine the serum levels of copper and zinc and their relationship with iron status in patients with sickle cell anemia (SCA). Methods: Sixty-six (66) subjects comprising thirty-five (35) HbSS steady state (SS) and thirty-one (31) HbAA as control subjects receiving treatment in the Hematology Clinic, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Kaduna State, Nigeria were recruited for the study. Atomic absorption spectrometer (AAS) was used to analyze the level of serum iron, copper, and zinc, while ferritin enzyme immunoassay was used to determine the serum ferritin. Results: Serum levels of copper and zinc were significantly lower compared to control in SCA (SS) subjects (p < 0.05). Similarly, serum iron and ferritin in SCA (SS), compared to control subjects, were significantly lower (p < 0.05). A positive correlation was observed in serum levels of copper and iron (r = 0.46 and p < 0.05). Likewise, a positive correlation also was observed between zinc and iron serum levels (r = 0.65 and p < 0.05). Furthermore, a significantly positive correlation was observed between copper and serum ferritin, and between zinc and serum ferritin (r = 0.44 and p < 0.05; r = 0.69 and p < 0.05), respectively. Conclusion: This study shows significantly lower levels of copper and zinc in subjects with SCA compared to control. Furthermore, low levels of copper and zinc correlate with iron deficiency in SCA patients. This may be due to the function of these trace elements in iron mobilization and utilization for hemoglobin and red blood cell synthesis and immune functions. This specific mechanism will require further investigation.

Fibrinogen-like 1: A hepatokine linking liver physiology to hematology.

A recent study identified the critical contribution of the hepatokine FGL1 to the regulation of iron metabolism during the recovery from anemia. FGL1 is secreted by hepatocytes in response to hypoxia to sequester BMP ligands and repress the transcription of the iron-regulatory hormone hepcidin. This process ensures the proper supply of iron to the bone marrow for new red blood cell synthesis and the restoration of physiological oxygen levels. FGL1 may therefore contribute to the recovery from common anemias and cause iron overload in chronic anemias with ineffective erythropoiesis, such as ß-thalassemia, dyserythropoietic anemia, and myelodysplastic syndromes. However, FGL1 has also been described as a regulator of hepatocyte proliferation, glucose homeostasis, and insulin signaling, as well as a mediator of liver steatosis and immune evasion. Chronic exposure to elevated levels of FGL1 during anemia may therefore have systemic metabolic effects besides iron regulation and erythropoiesis. Here, we are providing an overview of the proposed functions of FGL1 in physiology and pathophysiology.

Iron Status Assessment in Chronic Kidney Disease Patients Preceding Dialysis: An Exploration of Anemia and Iron Deficiency

Objective: The most common kind of anemia, iron deficiency anemia (IDA), is very burdensome for those with chronic kidney disease (CKD). The incidence of IDA rises as renal function deteriorates. The incidence of IDA in CKD patients before the need for dialysis has not been well documented in Pakistan, even though the major cause of anemia in CKD individuals is a shortage of erythrocyte a hormone generated by the kidneys that stimulates red blood cell synthesis. This study's goal is to identify the incidence of IDA in people with kidney failure who are still not receiving dialysis. Methods: We included 188 pre-dialysis CKD patients, ages 18 to 75, of both sexes. Patients with apparent anemia-related reasons were eliminated. During OPD follow-up, it was then established what proportion of patients had IDA in their pre-dialysis CKD. Results: The patients who participated in the research had an average age of 46.03 years, with a standard deviation of 12.24 years. There were 188 patients in all, and 102 of them were men, making up around 54.26% of the sample. The study's 1.2 to 1 male-to-female ratio indicates that men were overrepresented. 73 people, or around 38.83% of the total patients in the research, were found to have iron deficiency anemia (IDA) among people with chronic kidney disease (CKD) who had not yet begun dialysis. Practical Implication: The causes of iron shortage in those with CKD are complicated by several variables, chief among them being decreased nutritional iron consumption and poor gastrointestinal absorption of iron, blood losses brought on by uremia-induced platelet disorder, and persistent inflammation related to CKD. As a result, owing to chronic inflammation causing a reactive rise in ferritin, individuals with CKD have much higher ferritin threshold levels for the absolute iron shortage. As a result, it is advised that patients with CKD before starting dialysis have blood ferritin levels below 100 µg/ml and over 200 µg/ml for those who are already receiving it Conclusions: According to the study, IDA occurs often in pre-dialysis CKD patients. By paying strict attention to the sources of IDA and replacing it, patients' outcomes may be improved. Keywords: anemia, dialysis, chronic kidney disease, erythrocyte, iron deficiency, hormone

Acute cerebral ischemic stroke as a presentation of polycythemia vera: a case report and a review of literature.

Acute cerebral ischemic stroke as a presentation of polycythemia vera: a case report and a review of literature.

5610611 REAL-WORLD EVIDENCE CHARACTERIZING THE BURDEN OF DISEASE IN ALPHA AND BETA THALASSEMIA PATIENTS IN THE USA: AN INTERIM ANALYSIS

Introduction: Thalassemia is a rare disease caused by impaired red blood cell synthesis of α and/or β globin chains, resulting in ineffective erythropoiesis and chronic hemolytic anemia that may require transfusion therapy. There is a lack of real-world data describing disease burden in thalassemia patients, particularly those with non-transfusion-dependent (NTD) thalassemia and α-thalassemia. This analysis aimed to characterize the burden of disease in patients with thalassemia in the USA. Methods: Data were collected via the Adelphi Thalassemia Disease Specific Programme™, a point-in-time survey of thalassemia-treating physicians and their patients in the USA. Data collection started June 2022 and is ongoing, with data presented here from an interim analysis as of 24th August 2022. Physicians completed a structured online survey for the consecutive patients with α-thalassemia (α-thal) or β-thalassemia (β-thal) seen during the study period. Ethics exemption was obtained from Pearl Institutional Review Board. Results: A total of 28 hematologists/hematologist-oncologists completed surveys for 127 patients, 55 (43%) with α-thal and 72 (57%) with β-thal. Mean patient age was 36.5 and 31.0 years for α-thal and β-thal, and 29 (53%) and 41 (57%) patients were male, respectively. Forty-three (78%) patients with α-thal were trait/carrier (Table 1), and β-thal intermedia (36 [50%]) was the most common type of β-thal. The most frequently physician-reported thalassemia-related symptoms/complications experienced by patients with α-thal and β- thal at the time of data collection were fatigue (28/49 [57%] and 31/60 [52%%], respectively) and anemia (24/49 [49%] and 32/60 [53%], respectively). Seven (13%) patients with α-thal and 10 (14%) with β-thal were considered transfusion dependent (TD) by their physicians while the remaining patients were considered NTD. The most common reason for being considered TD was high risk of patient mortality without transfusions (3/7 [43%]) for α-thal and patient requires multiple transfusions a year due to low blood counts/low hemoglobin (8/10[80%]] for β-thal. Where known, in the 12 months prior to data collection, patients with physician-defined TD α-thal and β-thal received a median of 2.0 (range: 2-12) and 5.0 (range: 2-10) blood transfusions, whilst patients with physician-defined NTD α-thal and β-thal received a median of 0.0 (range: 0-3) and 1.0 (range: 0-3) blood transfusions respectively. Where known, physicians reported that patients with TD α-thal (n=7) and β-thal (n=9) had an average pre-transfusion mean hemoglobin of 10.9 g/dL and 8.4 g/dL and NTD α-thal (n=42) and β- thal (n=59) had a mean hemoglobin of 10.2 g/dL and 9.6 g/dL, respectively. Iron overload due to transfusions was reported in 5/41 (12%) of α-thal and 14/61 (23%) of β-thal patients. Iron chelation was prescribed in 34 (27%) of patients, luspatercept in 23 (18%) and hydroxyurea in 20 (16%). The most frequently reported issues/unmet need for iron chelation was ‘treatment does not reduce the severity of symptoms’ (9/34 [26%]), for luspatercept was ‘patient has to take time off work’ (7/23 [30%]), and for hydroxyurea ‘treatment does not reduce patient’s fatigue’ (7/20 [35%]) patients (Table 2). Conclusion: Despite currently available treatment approaches, both α- and β-thalassemia patients still experience substantial disease burden. Effective and convenient treatment approaches that target fatigue and improve Hb remain an unmet need for many patients.

Legal and Ethical Discourse of Saviour Sibling: How Should Indonesia Respond to this New Trend?

Thalassemia major is a genetic condition characterized by an inefficient synthesis of red blood cells which can be cured by bone marrow transplantation surgery. However, getting a matching donor is a challenging task. Therefore, some people have been using the “saviour sibling” procedure wherein a sibling is born to be a donor for their sibling. This procedure, however, has been raising debate, especially concerning bioethics. Indonesia, a country with a high number of people who suffer from such an abnormal genetic condition, needs to be aware of this procedure and its policy framework. This paper conducts a comparative study in identifying and analyzing how saviour sibling is regulated in countries other than Indonesia. Besides, it discusses the legal and ethical implications of saviour sibling procedures in Indonesia. It is a cross-discipline research that combines legal research in the fields of health law, human rights law, and private law and resources from medical science. The analysis is established by using normative, comparative, and ethical approaches. This study found a disparity in the policy framework between countries because such a procedure is in the grey zone between bioethics and technologies. Nevertheless, no rights are violated because the child would live a life of physical and mental well-being. This procedure also plays a critical role in developing medical technology. In bioethics, the saviour sibling procedure begs whether the conceived sibling is just a means to an end, a mere commodity. In Indonesia, the legal framework on health technology involving human subjects is still relatively lax in regulating saviour siblings. Therefore, this study suggests that Indonesia needs to consider the diverse local wisdom as the foundation of its bioethics in regulating saviour sibling in the future.

Management of Zygomatic Arch Fracture in Polycythemia Vera Patient-A Case Report

Polycythemia vera (PV) is a myeloproliferative neoplastic condition characterized by an unregulated synthesis of red blood cells (RBCs). There is often simultaneous stimulation of the megakaryocytic and myeloid lineages; this causes an increase in the synthesis of white blood cells and platelets2. As a result, there is an increased risk of thrombosis and bleeding. Due to the extensive vascular network of the face and jaw7 and limited surgical access to perform hemostasis, traumatic injuries and surgical procedures are among the most common causes of increased blood loss. Zygomatic bone fracture is one of the most frequent fractures of the facial skeleton. The zygomatic bone is a strong bone that supports the maxilla and the skull base. However, its prominence makes it highly susceptible, mainly when impact occurs on both sides of the face4. Facial bone fractures are associated with 1–11% excess blood loss. These complications have the potential to increase perioperative morbidity and mortality significantly. Adequate precautions must be taken in treating these patients for successful outcomes. The management of patients with PV includes therapeutic preoperative phlebotomy, increased fluid intake, and antiplatelet therapy. This report demonstrates the management of a complex procedure such as maxillofacial trauma in a PV patient with a normal coagulation profile.

Ameliorating effects of probiotics on alterations in iron homeostasis and inflammation in COVID-19.

IntroductionThe coronavirus disease (COVID-19) is caused by the severe acute syndrome coronavirus-2 (SARS-COV-2) and still threatens human life. This pandemic is still causing increased mortality throughout the world. Many recent studies have been conducted to discover the pathophysiology of this virus.Material and methodsHowever, in this narrative review, we attempted to summarize some of the alterations in physiological pathways that were evident in this viral invasion. Excessive inflammation that progresses to cytokine storm, changes in humoral and cell-mediated immunity, and observed alterations in iron metabolism are included in the pathogenesis of the virus. Iron homeostasis disturbances may persist for more than two months after the onset of COVID-19, which may lead to reduced iron bioavailability, hypoferremia, hyperferritinemia, impaired hemoglobin, and red blood cell synthesis. Furthermore, hypoferriemia may impair immune system function. Until now, the traditional treatments discovered are still being tried.ResultsHowever, using probiotics as an adjuvant was shown to have beneficial effects on both iron homeostasis and immunity in COVID-19. Herein, we discussed the possible mechanisms achieved by probiotics to ameliorate iron and immunity changes based on the available literature.ConclusionWe concluded that supplementing probiotics with conventional therapy may improve COVID-19 symptoms and outcomes. Taking into consideration the use of good quality probiotics and appropriate dosage, undesirable effects can be avoided.

Atypical Red Blood Cells Are Prevalent in California Sea Lion Pups Born during Anomalous Sea Surface Temperature Events.

To date, there is limited knowledge of the effects that abnormal sea surface temperature (SST) can have on the physiology of neonate pinnipeds. However, maternal nutritional deficiencies driven by alimentary restrictions would expectedly impact pinniped development and fitness, as an adequate supply of nutrients is essential for growth and proper functioning of all body systems, including red blood cell synthesis and clearance. Here, we investigated red blood cell morphology of California sea lion (CSL) pups from the San Benito Archipelago born during the 2014 and 2015 anomalously high SST events recorded in the northeastern Pacific Ocean. We examined whether atypical erythrocyte morphologies were more common in 2015, when the high SST event was more pronounced, and whether the stable isotope signature of pup fur, as an indicator of maternal feeding strategies, accounted for the number of atypical cells. Various atypical erythrocyte morphologies were more prevalent and more abundant than reference values. Evidence of iron deficiency was found in both years, and only pups born in 2014 showed evidence of active erythropoiesis. Microcytes and reticulocytes were more common in pups with higher isotopic δ13C and lower δ15N values, suggesting a probable relationship between maternal feeding strategies and the effect of climatic anomalies on red blood cell physiology of their pups. As developing pinnipeds require increased oxygen storage capacity for diving and foraging, the presence of atypical erythrocytes could be relevant to CSL pup fitness if the underlying cause is not reverted. This study is a first step to explore the effects that climatic alterations in the marine environment can have on the blood physiology of developing individuals.

Cobalt use and regulation in horseracing: a review

Cobalt, atomic weight 58.9, is a metallic element and environmental substance found in the animal in microgram quantities, predominantly as vitamin B12, but is also a component of at least one mammalian enzyme unassociated with B12. Cobalt is a required trace mineral and has long been administered as a dietary supplement to humans and animals. Cobalt deficiency outside of its requirement in vitamin B12 has not been reported in humans. The administration of cobalt salts was once standard treatment for anaemia in humans, owing to its ability to stimulate red blood cell synthesis. Elemental cobalt acts by stabilising hypoxia inducible factor (HIF-1α), which activates the erythropoietin gene, which in turn increases haemoglobin/red blood cell synthesis, which had led to a presumption that cobalt may be performance enhancing in athletes. Administration of cobalt in amounts sufficient to significantly increase the haematocrit are associated with risk of toxicity in humans, and the only cobalt administration study in horses showed no effect on red blood cell parameters or toxicity. Because of the perception that cobalt administration may enhance athletic performance, racing regulators have recently begun to restrict cobalt use in horseracing which has led to the introduction of cobalt thresholds in several racing jurisdictions. The International Federation of Horseracing Authorities is considering an international regulatory threshold for cobalt of 100 ng/ml in urine, based on studies performed in five different countries. In the United States, the Racing Commissioners International has recently set a primary plasma threshold of 25 ng/ml and secondary threshold of 50 ng/ml. One New York and New Jersey racetrack owner has initiated testing for cobalt and has denied his facilities to trainers whose horses tested positive for excessive quantities of cobalt. This review seeks to summarise what is known about the use of cobalt in horse racing.

Assessment of Maternal Folic Acid and Vitamin B12 Supplement with Foetus Growth

The intrauterine growth & development of foetus is most susceptible stage in the human life cycle. The pregnant woman necessities extra quantities of nearly all essential nutrients to sustenance the growth and development of the foetus. In last few years, the requirement for additional folic acid before and during pregnancy has been extensively discovered, as there is association of it with the neural tube defects. And vitamin B12 is needed for synthesis of red blood cells. The maternal folic acid and vitamin B12 are linked with birth weight & body proportions of their newborn. Hence to get the normal weight baby delivered supplementation of folic acid and vitamin B12 is necessary. On this point the present assesment was designed to assess maternal folate & vitamin B12 status with respect to birth weight & body proportions of their newborn. The level of the folic acid and vitamin B12 was found to be very less in the women’s who had delivered the lower weight babies. This findings are similar to the reported study in the literature. So based on the already reported study and the present study we can conclude that the folic acid & vitamin B12 are two important supplements necessary for the normal baby growth.

Altered erythropoiesis and iron metabolism in carriers of thalassemia.

The thalassemia syndromes (α- and β-thalassemia) are the most common and frequent disorders associated with ineffective erythropoiesis. Imbalance of α- or β-globin chain production results in impaired red blood cell synthesis, anemia, and more erythroid progenitors in the blood stream. While patients affected by these disorders show definitive altered parameters related to erythropoiesis, the relationship between the degree of anemia, altered erythropoiesis, and dysfunctional iron metabolism has not been investigated in both α-thalassemia carriers (ATC) and β-thalassemia carriers (BTC). Here, we demonstrate that ATC have a significantly reduced hepcidin and increased soluble transferrin receptor levels but relatively normal hematological findings. In contrast, BTC have several hematological parameters significantly different from controls, including increased soluble transferrin receptor and erythropoietin levels. These changes in both groups suggest an altered balance between erythropoiesis and iron metabolism. The index sTfR/log ferritin and (hepcidin/ferritin)/sTfR are, respectively, increased and reduced relative to controls, proportional to the severity of each thalassemia group. In conclusion, we showed in this study, for the first time in the literature, that thalassemia carriers have altered iron metabolism and erythropoiesis.

β-Thalassemia and Polycythemia vera: Targeting chronic stress erythropoiesis

β-Thalassemia and Polycythemia vera: Targeting chronic stress erythropoiesis

Developing glycoproteomic analysis of erythropoietin: towards discovering biomarkers for drug abuse

Developing glycoproteomic analysis of erythropoietin: towards discovering biomarkers for drug abuse

Vitamin B-12.

Vitamin B-12.

From kidney development to drug delivery and tissue engineering strategies in renal regenerative medicine

From kidney development to drug delivery and tissue engineering strategies in renal regenerative medicine

Avaliação da anemia em crianças da cidade de Campina Grande, Paraíba, Brasil

Avaliação da anemia em crianças da cidade de Campina Grande, Paraíba, Brasil