1
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Barbo M, Ravnik-Glavač M. Extracellular Vesicles as Potential Biomarkers in Amyotrophic Lateral Sclerosis. Genes (Basel) 2023; 14:genes14020325. [PMID: 36833252 PMCID: PMC9956314 DOI: 10.3390/genes14020325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is described as a fatal and rapidly progressive neurodegenerative disorder caused by the degeneration of upper motor neurons in the primary motor cortex and lower motor neurons of the brainstem and spinal cord. Due to ALS's slowly progressive characteristic, which is often accompanied by other neurological comorbidities, its diagnosis remains challenging. Perturbations in vesicle-mediated transport and autophagy as well as cell-autonomous disease initiation in glutamatergic neurons have been revealed in ALS. The use of extracellular vesicles (EVs) may be key in accessing pathologically relevant tissues for ALS, as EVs can cross the blood-brain barrier and be isolated from the blood. The number and content of EVs may provide indications of the disease pathogenesis, its stage, and prognosis. In this review, we collected a recent study aiming at the identification of EVs as a biomarker of ALS with respect to the size, quantity, and content of EVs in the biological fluids of patients compared to controls.
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2
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Paydarnia P, Mayeli M, Shafie M, Agah E, Hasani SA, Jazani MR, Sarraf P. Alterations of the serum and CSF ferritin levels and the diagnosis and prognosis of amyotrophic lateral sclerosis. eNeurologicalSci 2021; 25:100379. [PMID: 34869924 PMCID: PMC8626833 DOI: 10.1016/j.ensci.2021.100379] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
Background The ALS diagnostic challenges necessitate more robust diagnostic and prognostic methods. A potential biomarker in this regard is the alterations of ferritin levels in the serum and CSF of patients compared to controls. Methods The CSF and serum ferritin levels were measured in 50 ALS cases and 50 control patients with predefined exclusion criteria. The ELISA method was utilized for laboratory measurement and was statistically analyzed using the SPSS. Results Heightened serum ferritin levels in cases were not statistically significant. However, CSF ferritin levels were significantly higher in ALS patients (P < 0.001). Serum ferritin levels were significantly negatively correlated with the disease duration (P = 0.015) and were significantly positively correlated with the disease progression rate (DPR) (P = 0.012). Conclusion Heightened CSF ferritin levels can be used for the diagnosis of ALS. The correlation between the serum ferritin levels with the DPR and its correlation with the disease duration suggests potential prognostic utilities. Elevated serum ferritin level in patients with ALS is insignificant. CSF ferritin levels are significantly higher in ALS patients. Serum ferritin levels are negatively correlated with the disease duration. Serum ferritin levels are positively correlated with the disease progression rate.
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Affiliation(s)
- Parastou Paydarnia
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Mayeli
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahan Shafie
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Agah
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyede Anis Hasani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rashidi Jazani
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Sarraf
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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3
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Cheng Y, Chen Y, Shang H. Aberrations of biochemical indicators in amyotrophic lateral sclerosis: a systematic review and meta-analysis. Transl Neurodegener 2021; 10:3. [PMID: 33419478 PMCID: PMC7792103 DOI: 10.1186/s40035-020-00228-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence has suggested that the pathological changes in amyotrophic lateral sclerosis (ALS) are not only confined to the central nervous system but also occur in the peripheral circulating system. Here, we performed a meta-analysis based on the PubMed, EMBASE, EBSCO, and CNKI databases, to find out biochemical indicators associated with energy metabolism, iron homeostasis, and muscle injury that are altered in ALS patients and their correlations with ALS phenotypes. Forty-six studies covering 17 biochemical indicators, representing 5454 ALS patients and 7986 control subjects, were included in this meta-analysis. Four indicators, including fasting blood glucose level (weighted mean difference [WMD] = 0.13, 95% CI [0.06–0.21], p = 0.001), serum ferritin level (WMD = 63.42, 95% CI [48.12–78.73], p < 0.001), transferrin saturation coefficient level (WMD = 2.79, 95% CI [1.52–4.05], p < 0.001), and creatine kinase level (WMD = 80.29, 95% CI [32.90–127.67], p < 0.001), were significantly higher in the ALS patients, whereas the total iron-binding capacity (WMD = − 2.42, 95% CI [− 3.93, − 0.90], p = 0.002) was significantly lower in ALS patients than in the control subjects. In contrast, the other 12 candidates did not show significant differences between ALS patients and controls. Moreover, pooled hazard ratios (HR) showed significantly reduced survival (HR = 1.38, 95% CI [1.02–1.88], p = 0.039) of ALS patients with elevated serum ferritin levels. These findings suggest that abnormalities in energy metabolism and disruption of iron homeostasis are involved in the pathogenesis of ALS. In addition, the serum ferritin level is negatively associated with the overall survival of ALS patients.
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Affiliation(s)
- Yangfan Cheng
- Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,National Clinical Research Center for Geriatric, Laboratory of Neurodegenerative Disorders, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yongping Chen
- Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,National Clinical Research Center for Geriatric, Laboratory of Neurodegenerative Disorders, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, 610041, China. .,National Clinical Research Center for Geriatric, Laboratory of Neurodegenerative Disorders, West China Hospital, Sichuan University, Chengdu, 610041, China.
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4
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Moreira AC, Mesquita G, Gomes MS. Ferritin: An Inflammatory Player Keeping Iron at the Core of Pathogen-Host Interactions. Microorganisms 2020; 8:microorganisms8040589. [PMID: 32325688 PMCID: PMC7232436 DOI: 10.3390/microorganisms8040589] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 12/14/2022] Open
Abstract
Iron is an essential element for virtually all cell types due to its role in energy metabolism, nucleic acid synthesis and cell proliferation. Nevertheless, if free, iron induces cellular and organ damage through the formation of free radicals. Thus, iron levels must be firmly controlled. During infection, both host and microbe need to access iron and avoid its toxicity. Alterations in serum and cellular iron have been reported as important markers of pathology. In this regard, ferritin, first discovered as an iron storage protein, has emerged as a biomarker not only in iron-related disorders but also in inflammatory diseases, or diseases in which inflammation has a central role such as cancer, neurodegeneration or infection. The basic research on ferritin identification and functions, as well as its role in diseases with an inflammatory component and its potential as a target in host-directed therapies, are the main considerations of this review.
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Affiliation(s)
- Ana C. Moreira
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (G.M.); (M.S.G.)
- IBMC—Instituto de Biologia Molecular e Celular, Universidade do Porto, 4200-135 Porto, Portugal
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
- Correspondence:
| | - Gonçalo Mesquita
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (G.M.); (M.S.G.)
- IBMC—Instituto de Biologia Molecular e Celular, Universidade do Porto, 4200-135 Porto, Portugal
| | - Maria Salomé Gomes
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (G.M.); (M.S.G.)
- IBMC—Instituto de Biologia Molecular e Celular, Universidade do Porto, 4200-135 Porto, Portugal
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
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5
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Johns SLM, Ishaque A, Khan M, Yang YH, Wilman AH, Kalra S. Quantifying changes on susceptibility weighted images in amyotrophic lateral sclerosis using MRI texture analysis. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:396-403. [PMID: 31025885 DOI: 10.1080/21678421.2019.1599024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: Susceptibility-weighted imaging (SWI) has been used to identify neurodegeneration in amyotrophic lateral sclerosis (ALS) through qualitative gross visual comparison of signal intensity. The aim of this study was to quantitatively identify cerebral degeneration in ALS on SWI using texture analysis. Methods: SW images were acquired from 17 ALS patients (58.4 ± 10.3 years, 13M/4F, ALSFRS-R 41.2 ± 4.1) and 18 healthy controls (56.3 ± 17.6 years, 9M/9F) at 4.7 tesla. Textures were computed within the precentral gyrus and basal ganglia and compared between patients and controls using ANCOVA with age and gender as covariates. Texture features were correlated with clinical measures in patients. Texture features found to be significantly different between patients and controls in the precentral gyrus were then used in a whole-brain 3D texture analysis. Results: The texture feature autocorrelation was significantly higher in ALS patients compared to healthy controls in the precentral gyrus and basal ganglia (p < 0.05). Autocorrelation correlated significantly with clinical measures such as disease progression rate and finger tapping speed (p < 0.05). Whole brain 3D texture analysis using autocorrelation revealed differences between ALS patients and controls within the precentral gyrus on SWI images (p < 0.001). Conclusion: Texture analysis on SWI can quantitatively identify cerebral differences between ALS patients and controls.
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Affiliation(s)
- Scott L M Johns
- a Department of Biological Sciences , University of Alberta , Edmonton , Canada
| | - Abdullah Ishaque
- b Neuroscience and Mental Health Institute , University of Alberta , Edmonton , Canada.,c Faculty of Medicine and Dentistry , University of Alberta , Edmonton , Canada
| | - Muhammad Khan
- c Faculty of Medicine and Dentistry , University of Alberta , Edmonton , Canada
| | - Yee-Hong Yang
- d Department of Computing Science , University of Alberta , Edmonton , Canada
| | - Alan H Wilman
- e Department of Biomedical Engineering , University of Alberta , Edmonton , Canada, and
| | - Sanjay Kalra
- b Neuroscience and Mental Health Institute , University of Alberta , Edmonton , Canada.,d Department of Computing Science , University of Alberta , Edmonton , Canada.,e Department of Biomedical Engineering , University of Alberta , Edmonton , Canada, and.,f Department of Medicine, Division of Neurology , University of Alberta , Edmonton , Canada
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6
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Verber NS, Shepheard SR, Sassani M, McDonough HE, Moore SA, Alix JJP, Wilkinson ID, Jenkins TM, Shaw PJ. Biomarkers in Motor Neuron Disease: A State of the Art Review. Front Neurol 2019; 10:291. [PMID: 31001186 PMCID: PMC6456669 DOI: 10.3389/fneur.2019.00291] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 03/06/2019] [Indexed: 12/17/2022] Open
Abstract
Motor neuron disease can be viewed as an umbrella term describing a heterogeneous group of conditions, all of which are relentlessly progressive and ultimately fatal. The average life expectancy is 2 years, but with a broad range of months to decades. Biomarker research deepens disease understanding through exploration of pathophysiological mechanisms which, in turn, highlights targets for novel therapies. It also allows differentiation of the disease population into sub-groups, which serves two general purposes: (a) provides clinicians with information to better guide their patients in terms of disease progression, and (b) guides clinical trial design so that an intervention may be shown to be effective if population variation is controlled for. Biomarkers also have the potential to provide monitoring during clinical trials to ensure target engagement. This review highlights biomarkers that have emerged from the fields of systemic measurements including biochemistry (blood, cerebrospinal fluid, and urine analysis); imaging and electrophysiology, and gives examples of how a combinatorial approach may yield the best results. We emphasize the importance of systematic sample collection and analysis, and the need to correlate biomarker findings with detailed phenotype and genotype data.
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Affiliation(s)
- Nick S Verber
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Stephanie R Shepheard
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Matilde Sassani
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Harry E McDonough
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Sophie A Moore
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - James J P Alix
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Iain D Wilkinson
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Tom M Jenkins
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Pamela J Shaw
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
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7
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Sun Q, Yang F, Wang H, Cui F, Li Y, Li S, Ren Y, Lan W, Li M, Zhu W, Sun X, He Z, Zhao X, Yang L, Huang X. Elevated serum ferritin level as a predictor of reduced survival in patients with sporadic amyotrophic lateral sclerosis in China: a retrospective study. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:186-191. [PMID: 30652532 DOI: 10.1080/21678421.2018.1555599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: The objective of this study was to compare iron metabolic variables in the serum and cerebrospinal fluid (CSF) of patients with sporadic amyotrophic lateral sclerosis (sALS) with those of patients with multiple system atrophy (MSA) and control subjects. We also assessed the correlations of these variables with sALS progression and severity and estimated their roles in predicting prognosis. Methods: We retrospectively collected iron metabolic parameters, including serum levels of iron, ferritin, transferrin levels and total iron binding capacity and the CSF level of ferritin, from 435 sALS patients, 176 MSA patients and 431 control subjects. Results: Serum ferritin levels were significantly higher in the sALS group compared with the MSA and control groups in both males (p = 0.001 and p < 0.0001, respectively) and females (p = 0.034 and p < 0.0001, respectively). However, serum transferrin levels were significantly lower in females of the sALS group compared with the MSA (p = 0.016) and control (p = 0.015) groups. The CSF ferritin level and the serum levels of total iron binding capacity and iron were similar among the sALS, MSA and control groups. Survival analysis demonstrated that higher serum ferritin levels were predictors of reduced survival of sALS patients. No correlations between iron metabolic variables and clinical parameters were found. Conclusion: An elevated serum ferritin level is associated with reduced survival of sALS patients. However, the levels of iron metabolic parameters were not associated with clinical deterioration or disease severity at diagnosis.
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Affiliation(s)
- Qionghua Sun
- a College of Medicine , Nankai University , Tianjin , China
| | - Fei Yang
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Hongfen Wang
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Fang Cui
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Yanran Li
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Siyuan Li
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Yuting Ren
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China.,c Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Wenjie Lan
- a College of Medicine , Nankai University , Tianjin , China
| | - Mao Li
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Wenjia Zhu
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China.,c Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Xiaosun Sun
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Zhengqing He
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Xue Zhao
- a College of Medicine , Nankai University , Tianjin , China
| | - Li Yang
- a College of Medicine , Nankai University , Tianjin , China
| | - Xusheng Huang
- a College of Medicine , Nankai University , Tianjin , China.,b Department of Neurology , Chinese PLA General Hospital , Beijing , China
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8
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Petillon C, Hergesheimer R, Puy H, Corcia P, Vourc'h P, Andres C, Karim Z, Blasco H. The Relevancy of Data Regarding the Metabolism of Iron to Our Understanding of Deregulated Mechanisms in ALS; Hypotheses and Pitfalls. Front Neurosci 2019; 12:1031. [PMID: 30697143 PMCID: PMC6341213 DOI: 10.3389/fnins.2018.01031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 12/19/2018] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease caused by the loss of motor neurons. Its etiology remains unknown, but several pathophysiological mechanisms are beginning to explain motor neuronal death, as well as oxidative stress. Iron accumulation has been observed in both sporadic and familial forms of ALS, including mouse models. Therefore, the dysregulation of iron metabolism could play a role in the pathological oxidative stress in ALS. Several studies have been undertaken to describe iron-related metabolic markers, in most cases focusing on metabolites in the bloodstream due to few available data in the central nervous system. Reports of accumulation of iron, high serum ferritin, and low serum transferrin levels in ALS patients have encouraged researchers to consider dysregulated iron metabolism as an integral part of ALS pathophysiology. However, it appears complicated to suggest a general mechanism due to the diversity of models and iron markers studied, including the lack of consensus among all of the studies. Regarding clinical study reports, most of them do not take into account confusion biases such as inflammation, renal dysfunction, and nutritional status. Furthermore, the iron regulatory pathways, particularly involving hepcidin, have not been thoroughly explored yet within the pathogenesis of iron overload in ALS. In this sense, it is also essential to explore the relation between iron overload and other ALS-related events, such as neuro-inflammation, protein aggregation, and iron-driven cell death, termed ferroptosis. In this review, we point out limits of the designs of certain studies that may prevent the understanding of the role of iron in ALS and discuss the relevance of the published data regarding the pathogenic impact of iron metabolism deregulation in this disease and the therapeutics targeting this pathway.
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Affiliation(s)
| | | | - Hervé Puy
- Centre de Recherches sur l'Inflammation, Equipe "Hème, Fer et Maladies Inflammatoires", UMR 1149/ERL CNRS 8252, Université Paris Diderot Paris 7, UFR de Médecine Site Bichat, Paris, France
| | - Philippe Corcia
- INSERM, U1253, Université de Tours, Tours, France.,Centre SLA, Service de Neurologie, CHRU de Tours, Tours, France
| | - Patrick Vourc'h
- Laboratoire de Biochimie, CHRU de Tours, Tours, France.,INSERM, U1253, Université de Tours, Tours, France
| | - Christian Andres
- Laboratoire de Biochimie, CHRU de Tours, Tours, France.,INSERM, U1253, Université de Tours, Tours, France
| | - Zoubida Karim
- Centre de Recherches sur l'Inflammation, Equipe "Hème, Fer et Maladies Inflammatoires", UMR 1149/ERL CNRS 8252, Université Paris Diderot Paris 7, UFR de Médecine Site Bichat, Paris, France
| | - Hélène Blasco
- Laboratoire de Biochimie, CHRU de Tours, Tours, France.,INSERM, U1253, Université de Tours, Tours, France
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9
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Hu X, Yang Y, Su J, Yao C. Meta-analysis of the relationship between amyotrophic lateral sclerosis and susceptibility to serum ferritin level elevation. ACTA ACUST UNITED AC 2018; 21:120-5. [PMID: 27094521 PMCID: PMC5107265 DOI: 10.17712/nsj.2016.2.20150482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: To study the possible relationship between amyotrophic lateral sclerosis (ALS) patients and their susceptibility to serum ferritin level elevation. Methods: We searched the PubMed, Springer, Medline, and OVID databases for any-language original research articles relating to serum ferritin levels in ALS patients published between June 2005 and June 2015. The search term used with ‘amyotrophic lateral sclerosis’, ‘ferritins’, ‘ferritin’, ‘iron’, ‘iron stores, ‘iron status, ‘iron intake’, and ‘iron consumption’. The meta-analysis software RevMan 5.0 was used for the heterogeneity test, and to test for the overall effect. Results: Six case-control studies met our inclusion criteria including data from a total of 1813 participants. The mean difference of serum ferritin levels comparing ALS to healthy controls was 69.05 (95% confidence interval: 52.56-85.54; p<0.00001); heterogeneity: p=0.03; I2=50%. The findings indicate homology in the sensitivity analysis. Funnel plot assessment indicated publication bias. Conclusion: Our results suggest that ALS is positively associated with susceptibility to the elevation of serum ferritin levels; however, further evidence is required to support this.
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Affiliation(s)
- Xiaohui Hu
- Department of Neurology, Jingzhou Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jingzhou, China
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10
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Emerging and Dynamic Biomedical Uses of Ferritin. Pharmaceuticals (Basel) 2018; 11:ph11040124. [PMID: 30428583 PMCID: PMC6316788 DOI: 10.3390/ph11040124] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022] Open
Abstract
Ferritin, a ubiquitously expressed protein, has classically been considered the main iron cellular storage molecule in the body. Owing to the ferroxidase activity of the H-subunit and the nucleation ability of the L-subunit, ferritin can store a large amount of iron within its mineral core. However, recent evidence has demonstrated a range of abilities of ferritin that extends well beyond the scope of iron storage. This review aims to discuss novel functions and biomedical uses of ferritin in the processes of iron delivery, delivery of biologics such as chemotherapies and contrast agents, and the utility of ferritin as a biomarker in a number of neurological diseases.
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11
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Yu J, Wang N, Qi F, Wang X, Zhu Q, Lu Y, Zhang H, Che F, Li W. Serum ferritin is a candidate biomarker of disease aggravation in amyotrophic lateral sclerosis. Biomed Rep 2018; 9:333-338. [PMID: 30233786 DOI: 10.3892/br.2018.1138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/23/2018] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. The mechanism that defines the loss of neurons in ALS is still not clearly understood, and there is no effective therapy to block its progression. Previous studies indicate that a disorder of iron homeostasis exists in ALS and based on this, the change of serum iron and ferritin and the association between iron metabolism and clinical features in Chinese Han patients with ALS was further investigated in the present study, in order to define its pathogenesis. Two cohorts were established: An ALS group consisting of 24 patients and a control group consisting of 38 healthy volunteers. Venous blood samples were collected for serum iron and ferritin analysis. The results indicated that the levels of serum iron were significantly decreased in patients with ALS (P<0.05), while there was no significant difference in serum ferritin between the ALS and control groups. However, the levels of serum ferritin were increased significantly in ALS patients with bulbar-onset (vs. limb-onset in females), dysphagia (vs. without dysphagia), longer disease duration (>12 months vs. ≤12 months in males) and lower ALS Functional Rating Scale-Revised score (<33 vs. ≥33; P<0.05). These results suggested that there was dysregulation of iron metabolism in Chinese Han patients with ALS and that serum ferritin may be a candidate biomarker of aggravation in these patients.
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Affiliation(s)
- Jixu Yu
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China.,Central Laboratory, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Nian Wang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Faying Qi
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Xianjun Wang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Qiyi Zhu
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Yucheng Lu
- Central Laboratory, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Huiling Zhang
- Clinical Laboratory, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Fengyuan Che
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China.,Central Laboratory, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Wei Li
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
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12
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Goozee K, Chatterjee P, James I, Shen K, Sohrabi HR, Asih PR, Dave P, ManYan C, Taddei K, Ayton SJ, Garg ML, Kwok JB, Bush AI, Chung R, Magnussen JS, Martins RN. Elevated plasma ferritin in elderly individuals with high neocortical amyloid-β load. Mol Psychiatry 2018; 23:1807-1812. [PMID: 28696433 DOI: 10.1038/mp.2017.146] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/14/2017] [Accepted: 05/26/2017] [Indexed: 12/14/2022]
Abstract
Ferritin, an iron storage and regulation protein, has been associated with Alzheimer's disease (AD); however, it has not been investigated in preclinical AD, detected by neocortical amyloid-β load (NAL), before cognitive impairment. Cross-sectional analyses were carried out for plasma and serum ferritin in participants in the Kerr Anglican Retirement Village Initiative in Aging Health cohort. Subjects were aged 65-90 years and were categorized into high and low NAL groups via positron emission tomography using a standard uptake value ratio cutoff=1.35. Ferritin was significantly elevated in participants with high NAL compared with those with low NAL, adjusted for covariates age, sex, apolipoprotein E ɛ4 carriage and levels of C-reactive protein (an inflammation marker). Ferritin was also observed to correlate positively with NAL. A receiver operating characteristic curve based on a logistic regression of the same covariates, the base model, distinguished high from low NAL (area under the curve (AUC)=0.766), but was outperformed when plasma ferritin was added to the base model (AUC=0.810), such that at 75% sensitivity, the specificity increased from 62 to 71% on adding ferritin to the base model, indicating that ferritin is a statistically significant additional predictor of NAL over and above the base model. However, ferritin's contribution alone is relatively minor compared with the base model. The current findings suggest that impaired iron mobilization is an early event in AD pathogenesis. Observations from the present study highlight ferritin's potential to contribute to a blood biomarker panel for preclinical AD.
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Affiliation(s)
- K Goozee
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,Anglicare, Sydney, NSW, Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia.,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Alzheimer Research Foundation, Perth, WA, Australia.,KaRa Institute of Neurological Disease, Sydney, NSW, Australia.,The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - P Chatterjee
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,KaRa Institute of Neurological Disease, Sydney, NSW, Australia
| | - I James
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - K Shen
- Australian eHealth Research Centre, CSIRO, Floreat, WA, Australia
| | - H R Sohrabi
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Alzheimer Research Foundation, Perth, WA, Australia.,The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - P R Asih
- KaRa Institute of Neurological Disease, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - P Dave
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,Anglicare, Sydney, NSW, Australia
| | - C ManYan
- Anglicare, Sydney, NSW, Australia
| | - K Taddei
- School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Alzheimer Research Foundation, Perth, WA, Australia
| | - S J Ayton
- Florey Department of Neuroscience and Mental Health, University of Melbourne University, Melbourne, VIC, Australia
| | - M L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - J B Kwok
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - A I Bush
- The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne University, Melbourne, VIC, Australia
| | - R Chung
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - J S Magnussen
- Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | - R N Martins
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia. .,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia. .,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia. .,McCusker Alzheimer Research Foundation, Perth, WA, Australia. .,KaRa Institute of Neurological Disease, Sydney, NSW, Australia. .,The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia.
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13
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Zheng Y, Gao L, Wang D, Zang D. Elevated levels of ferritin in the cerebrospinal fluid of amyotrophic lateral sclerosis patients. Acta Neurol Scand 2017; 136:145-150. [PMID: 27804118 DOI: 10.1111/ane.12708] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of the study was to detect changes in the levels of ferritin heavy chain (FHC), ferritin light chain (FLC), and transferrin in the cerebrospinal fluid (CSF) and serum of amyotrophic lateral sclerosis (ALS) patients and to analyze the correlations between the levels of these proteins and various clinical parameters. METHODS Cerebrospinal fluid and serum samples were obtained from 54 ALS patients and 46 non-inflammatory neurological disease control (non-INDC) patients. CSF and serum FHC, FLC, and transferring levels were measured via the enzyme-linked immunosorbent method using a commercial ELISA kit, and the times from onset (durations), ALS functional rating scale-revised (ALSFRS-r) scores, and disease progression rates (DPRs) were analyzed by registered neurologists. Statistical analysis was performed via Prism software. RESULTS Compared with controls, ALS patients exhibited significantly increased FHC and FLC levels in CSF, which were positively correlated with DPR and negatively correlated with duration. Serum transferrin levels were significantly increased in ALS patients but were not correlated with disease progression. FHC and FLC in CSF rapidly increased as the disease worsened. CONCLUSIONS This study demonstrated that the clinical measurement of FHC and FLC in CSF may be beneficial for disease differentiation and evaluating progression in patients with ALS. Compared with levels in serum, the levels of FHC and FLC in CSF might be more reliable for diagnosing and assessing the progression of ALS.
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Affiliation(s)
- Y. Zheng
- Department of Neurology; Tianjin First Center Hospital; Tianjin Medical University; Tianjin China
| | - L. Gao
- Department of Neurology; Tianjin First Center Hospital; Tianjin Medical University; Tianjin China
| | - D. Wang
- Department of Neurology; Changchun Center Hospital; Changchun Jilin China
| | - D. Zang
- Department of Neurology; Tianjin First Center Hospital; Tianjin Medical University; Tianjin China
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14
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Che F, Wang G, Yu J, Wang X, Lu Y, Fu Q, Su Q, Jiang J, Du Y. Effects of epigallocatechin‑3‑gallate on iron metabolism in spinal cord motor neurons. Mol Med Rep 2017; 16:3010-3014. [PMID: 28677731 DOI: 10.3892/mmr.2017.6919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/17/2017] [Indexed: 11/05/2022] Open
Abstract
Accumulating evidence suggests that iron homeostasis is disordered in amyotrophic lateral sclerosis (ALS). In view of the promising performance of epigallocatechin‑3‑gallate (EGCG) in neuroprotection studies, the present study aimed to verify whether EGCG protects motor neurons in an ALS model, and whether it has any effects on iron metabolism using an ELISA and western blotting. The results demonstrated that EGCG decreased oxidative stress and protected motor neurons in the organotypic culture of the rat spinal cord. Furthermore, total iron levels increased significantly in the spinal cord following 3 weeks of treatment with threo‑hydroxyaspartate. In addition, the expression of influx proteins (transferrin receptor and divalent metal‑ion transporter 1) increased significantly. However, EGCG demonstrated no effect on total iron levels and the expression of influx proteins. In conclusion, EGCG leads to a decrease in oxidative stress levels, leading to motor neuron protection in the organotypic culture of a rat spinal cord; however, EGCG does not alter iron metabolism protein expression regulation.
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Affiliation(s)
- Fengyuan Che
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Guangying Wang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Jixu Yu
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Xianjun Wang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Yucheng Lu
- Central Laboratory, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Qingxi Fu
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Quanping Su
- Central Laboratory, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Jianzhang Jiang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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15
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Bozzo F, Mirra A, Carrì M. Oxidative stress and mitochondrial damage in the pathogenesis of ALS: New perspectives. Neurosci Lett 2017; 636:3-8. [DOI: 10.1016/j.neulet.2016.04.065] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/05/2016] [Accepted: 04/29/2016] [Indexed: 02/07/2023]
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16
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Enge TG, Ecroyd H, Jolley DF, Yerbury JJ, Dosseto A. Longitudinal assessment of metal concentrations and copper isotope ratios in the G93A SOD1 mouse model of amyotrophic lateral sclerosis. Metallomics 2017; 9:161-174. [DOI: 10.1039/c6mt00270f] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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17
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Puentes F, Malaspina A, van Noort JM, Amor S. Non-neuronal Cells in ALS: Role of Glial, Immune cells and Blood-CNS Barriers. Brain Pathol 2016; 26:248-57. [PMID: 26780491 DOI: 10.1111/bpa.12352] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/14/2016] [Indexed: 12/11/2022] Open
Abstract
Neurological dysfunction and motor neuron degeneration in amyotrophic lateral sclerosis (ALS) is strongly associated with neuroinflammation reflected by activated microglia and astrocytes in the CNS. In ALS endogenous triggers in the CNS such as aggregated protein and misfolded proteins activate a pathogenic response by innate immune cells. However, there is also strong evidence for a neuroprotective immune response in ALS. Emerging evidence also reveals changes in the peripheral adaptive immune responses as well as alterations in the blood brain barrier that may aid traffic of lymphocytes and antibodies into the CNS. Understanding the triggers of neuroinflammation is key to controlling neuronal loss. Here, we review the current knowledge regarding the roles of non-neuronal cells as well as the innate and adaptive immune responses in ALS. Existing ALS animal models, in particular genetic rodent models, are very useful to study the underlying pathogenic mechanisms of motor neuron degeneration. We also discuss the approaches used to target the pathogenic immune responses and boost the neuroprotective immune pathways as novel immunotherapies for ALS.
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Affiliation(s)
- Fabiola Puentes
- Neuroimmunology Unit, Queen Mary University of London, Neuroscience Centre, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK
| | - Andrea Malaspina
- Neuroimmunology Unit, Queen Mary University of London, Neuroscience Centre, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK
| | | | - Sandra Amor
- Neuroimmunology Unit, Queen Mary University of London, Neuroscience Centre, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK.,Department of Pathology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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18
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Connor JR, Patton SM, Oexle K, Allen RP. Iron and restless legs syndrome: treatment, genetics and pathophysiology. Sleep Med 2016; 31:61-70. [PMID: 28057495 DOI: 10.1016/j.sleep.2016.07.028] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/22/2016] [Accepted: 07/29/2016] [Indexed: 12/13/2022]
Abstract
In this article, we review the original findings from MRI and autopsy studies that demonstrated brain iron status is insufficient in individuals with restless legs syndrome (RLS). The concept of deficient brain iron status is supported by proteomic studies from cerebrospinal fluid (CSF) and from the clinical findings where intervention with iron, either dietary or intravenous, can improve RLS symptoms. Therefore, we include a section on peripheral iron status and how peripheral status may influence both the RLS symptoms and treatment strategy. Given the impact of iron in RLS, we have evaluated genetic data to determine if genes are directly involved in iron regulatory pathways. The result was negative. In fact, even the HFE mutation C282Y could not be shown to have a protective effect. Lastly, a consistent finding in conditions of low iron is increased expression of proteins in the hypoxia pathway. Although there is lack of clinical data that RLS patients are hypoxic, there are intriguing observations that environmental hypoxic conditions worsen RLS symptoms; in this chapter we review very compelling data for activation of hypoxic pathways in the brain in RLS patients. In general, the data in RLS point to a pathophysiology that involves decreased acquisition of iron by cells in the brain. Whether the decreased ability is genetically driven, activation of pathways (eg, hypoxia) that are designed to limit cellular uptake is unknown at this time; however, the data strongly support a functional rather than structural defect in RLS, suggesting that an effective treatment is possible.
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Affiliation(s)
- James R Connor
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA.
| | - Stephanie M Patton
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Konrad Oexle
- Institut für Humangenetik, Technische Universität, Munich, Germany
| | - Richard P Allen
- The Johns Hopkins University, Dep of neuroloy, Baltimore, MD USA
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