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Rahimova RR, Efendiyev AM, Shahverdiyeva IJ, Dashdamirova GS, Kerimova IA. Determination of the levels and possible associations of alpha2-macroglobulin with autoantibodies in the serum of patients with various forms of autoimmune thyroiditis. Biomed Khim 2024; 70:125-129. [PMID: 38711412 DOI: 10.18097/pbmc20247002125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Antibodies to thyroid peroxidase (AB-TPO), antibodies to thyroglobulin (AB-TG), and the content of α2-macroglobulin (α2-MG) have been studied in serum samples of patients with autoimmune thyroiditis (AIT). All the patients were divided into 3 groups depending on age: 25-35, 36-50, 51-65 years. We found a significant change in the thyroid panel parameters in AIT, but without significant changes in the average concentration of α2-MG in the age groups of patients. This may be due to the accumulation and retention of complexes of defective forms of α2-MG in the circulation associated with their decreased ability to bind to receptors.
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Lorinczova HT, Begum G, Renshaw D, Zariwala MG. Acute Administration of Bioavailable Curcumin Alongside Ferrous Sulphate Supplements Does Not Impair Iron Absorption in Healthy Adults in a Randomised Trial. Nutrients 2021; 13:nu13072300. [PMID: 34371810 PMCID: PMC8308323 DOI: 10.3390/nu13072300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/17/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Abstract
Ferrous sulphate (FS) is a cost effective, readily available iron supplement for iron deficiency (ID). The pro-oxidant effect of oral ferrous iron is known to induce inflammation, causing gastric side-effects and resulting in poor compliance. Curcumin is a potent antioxidant and has also been shown to exhibit iron chelation in-vitro, although it is not established whether these effects are retained in-vivo. The aim of this study was therefore to assess the influence of a formulated bioavailable form of curcumin (HydroCurcTM; 500 mg) on acute iron absorption and status in a double blind, placebo-controlled randomized trial recruiting 155 healthy participants (79 males; 26.42 years ± 0.55 and 76 females; 25.82 years ± 0.54). Participants were randomly allocated to five different treatment groups: iron and curcumin placebo (FS0_Plac), low dose (18 mg) iron and curcumin placebo (FS18_Plac), low dose iron and curcumin (FS18_Curc), high dose (65 mg) iron and curcumin placebo (FS65_Plac), and high dose iron and curcumin (FS65_Curc). Participants were provided with the supplements according to their relevant treatment groups at baseline (0 min), and blood collection was carried out at 0 min and at 180 min following supplementation. In the treatment groups, significant difference was observed in mean serum iron between baseline (0 min) and at end-point (180 min) (F (1, 144) = 331.9, p < 0.0001) with statistically significant intra-group increases after 180 min (p < 0.0001) in the FS18_Plac (8.79 µmol/L), FS18_Curc (11.41 µmol/L), FS65_Plac (19.09 µmol/L), and FS65_Curc (16.39 µmol/L) groups. A significant difference was also observed between the two time points in serum TIBC levels and in whole blood haemoglobin (HGB) in the treatment groups, with a significant increase (1.55%/2.04 g/L) in HGB levels from baseline to end-point observed in the FS65_Curc group (p < 0.05). All groups receiving iron demonstrated an increase in transferrin saturation (TS%) in a dose-related manner, demonstrating that increases in serum iron are translated into increases in physiological iron transportation. This study demonstrates, for the first time, that regardless of ferrous dose, formulated curcumin in the form of HydroCurc™ does not negatively influence acute iron absorption in healthy humans.
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Affiliation(s)
- Helena Tiekou Lorinczova
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK; (H.T.L.); (G.B.)
| | - Gulshanara Begum
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK; (H.T.L.); (G.B.)
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Institute for Health and Wellbeing, Coventry University, Priory St, Coventry CV1 5FB, UK;
| | - Mohammed Gulrez Zariwala
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK; (H.T.L.); (G.B.)
- Correspondence: ; Tel.: +44-20-7911-5000 (ext. 65086)
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Jacobson DL, Neri D, Gaskins A, Yee L, Mendez AJ, Hendricks K, Siminski S, Zash R, Hyzy L, Jao J. Maternal anemia and preterm birth among women living with HIV in the United States. Am J Clin Nutr 2021; 113:1402-1410. [PMID: 35104854 PMCID: PMC9034117 DOI: 10.1093/ajcn/nqaa441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Women living with HIV (WLHIV) have a higher prevalence of anemia than women without HIV, possibly related to the effects of HIV and antiretroviral medications. OBJECTIVES To estimate the prevalence of anemia in the third trimester of pregnancy and the effect of anemia on preterm births in WLHIV in the longitudinal, US-based Pediatric HIV/AIDS Cohort Study (PHACS). METHODS During the third trimester, we obtained up to three 24-hour dietary recalls to estimate daily intakes of nutrients and measured serum concentrations of iron, vitamin B6, vitamin B12, zinc, folate, ferritin, total iron-binding capacity (TIBC), and high sensitivity C-reactive protein. Third trimester anemia was defined as hemoglobin < 11 g/d and iron-deficiency anemia (IDA) was defined as low ferritin, high TIBC, and low transferrin saturation. A preterm birth was defined as birth at < 37 completed weeks of gestation, regardless of etiology. We fit separate modified Poisson regression models for each outcome (anemia, preterm birth) and each main exposure, adjusted for confounders, and report adjusted prevalence ratios (aPR) and 95% CIs. RESULTS Of the 267 WLHIV, 50% were anemic in the third trimester, of whom 43.5% (n = 57/131) had IDA. On average, women with anemia were younger, were more likely to be black, started antiretroviral medications in the second trimester, had a low CD4 count (<200 cells/mm3) early in pregnancy, and were less likely to meet recommended intakes for iron, B6, and folate. The prevalence of anemia was greater in WLHIV with a low CD4 count (aPR = 1.65; 95% CI: 1.20-2.27) and high HIV viral load (>10,000 copies/mL; aPR = 1.38; 95% CI: 1.02-1.87). In total, 16% of women delivered preterm. Anemia was associated with a 2-fold (aPR = 2.04; 95% CI: 1.12-3.71) higher prevalence of preterm births. CONCLUSIONS Anemia is common in pregnant WLHIV, highlighting the need to address the underlying factors and clinical outcomes of anemia in this population.
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Affiliation(s)
- Denise L Jacobson
- Center for Biostatistics in AIDS Research, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Daniela Neri
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Audrey Gaskins
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Lynn Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Armando J Mendez
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Leonard M Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Kristy Hendricks
- Dartmouth Medical School, Department of Pediatrics, Lebanon, NH, USA
| | - Suzanne Siminski
- Frontier Science Technology Research Foundation INC, Amherst Office, NY, USA
| | - Rebecca Zash
- Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Laurie Hyzy
- Frontier Science Technology Research Foundation INC, Amherst Office, NY, USA
| | - Jennifer Jao
- Division of Pediatric Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Adult Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Paparodis RD, Bantouna D, Karvounis E, Imam S, Jaume JC. Higher TSH Is Not Associated With Thyroid Cancer Risk in the Presence of Thyroid Autoimmunity. J Clin Endocrinol Metab 2020; 105:5835732. [PMID: 32391913 DOI: 10.1210/clinem/dgaa237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Higher-but-within-normal thyrotropin (thyroid-stimulating hormone, TSH) is associated with higher risk for differentiated thyroid cancer (DTC) in surgical series. Our recent clinical observations suggest that this is not the case in the presence of autoimmune thyroid disease (AITD). We designed the present study to clarify this controversy. METHODS We analyzed our prospectively collected database of patients referred for thyroid surgery at 2 tertiary care referral centers in Greece and the United States. We collected data for preoperative TSH, postoperative pathology, and thyroid peroxidase (TPO) antibodies titers. Subjects were subdivided into 2 groups, those with AITD (i.e., lymphocytic thyroiditis) and non-AITD. We excluded subjects with Graves disease, abnormal TSH (< 0.40 or > 4.50 mIU/mL), or recent use of levothyroxine. We compared the serum TSH among different groups using the Mann-Whitney test. RESULTS A total of 3973 subjects were screened; 1357 met exclusion criteria. After all exclusions, data from 1731 non-AITD subjects and 329 AITD subjects were included in the analysis. AITD subjects had higher TSH than non-AITD subjects (2.09 vs 1.48; P < 0.0001). TSH values were higher in DTC compared with benign histology only in non-AITD subjects (1.65 vs 1.40; P < 0.0001). Progressively higher TSH was associated with higher incidence of DTC only in non-AITD subjects (P < 0.0001). In AITD subjects, TSH was similar between groups with or without DTC (2.02 vs 2.14; P = 0.21). CONCLUSIONS TSH concentrations are not associated with the risk of developing DTC in the presence of thyroid autoimmunity, even though this seems to be the case for all other patients.
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Affiliation(s)
- Rodis D Paparodis
- Private Practice, Patras, Greece
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine and Center for Diabetes and Endocrine Research (CeDER), ProMedica Health System/University of Toledo, Toledo, Ohio
| | - Dimitra Bantouna
- Department of Pathology, University of Patras Hospital, Patras, Greece
| | | | - Shahnawaz Imam
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine and Center for Diabetes and Endocrine Research (CeDER), ProMedica Health System/University of Toledo, Toledo, Ohio
| | - Juan Carlos Jaume
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine and Center for Diabetes and Endocrine Research (CeDER), ProMedica Health System/University of Toledo, Toledo, Ohio
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Safian S, Esna-Ashari F, Borzouei S. Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus. Curr Diabetes Rev 2020; 16:895-899. [PMID: 31870270 DOI: 10.2174/1573399816666191223111833] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/30/2019] [Accepted: 12/09/2019] [Indexed: 12/30/2022]
Abstract
AIMS Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. BACKGROUND This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). METHODS A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24-28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. RESULTS There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). CONCLUSION Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.
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Affiliation(s)
- Shahin Safian
- Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farzaneh Esna-Ashari
- Department of Community Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shiva Borzouei
- Department of Endocrinology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Mulder TA, van den Dries MA, Korevaar TIM, Ferguson KK, Peeters RP, Tiemeier H. Organophosphate pesticides exposure in pregnant women and maternal and cord blood thyroid hormone concentrations. Environ Int 2019; 132:105124. [PMID: 31479957 PMCID: PMC6827719 DOI: 10.1016/j.envint.2019.105124] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND Animal studies suggest that organophosphate (OP) pesticides exposure affects thyroid function, but evidence in humans remains sparse and inconclusive. Gestational exposure is of particular interest, since thyroid hormone is essential for fetal brain development. OP pesticides are able to cross the placental and blood-brain barrier and may interfere with fetal development processes regulated by thyroid hormone. OBJECTIVE To investigate the association of gestational OP pesticides exposure during pregnancy with maternal and cord blood thyroid hormone concentrations. METHODS This study was embedded within Generation R (Rotterdam, the Netherlands), a prospective population-based birth cohort. Mother-child pairs with OP pesticides assessment and maternal (N = 715) or cord blood (N = 482) thyroid hormone measurements were included. OP pesticides exposure was assessed at <18, 18-25, and >25 weeks gestation by measuring six urinary dialkylphosphate (DAP) metabolites. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured in maternal and cord blood. Maternal measures also included total thyroxine (TT4) and TPO antibodies (TPOAbs). To study the association of creatinine-adjusted DAP metabolite concentrations with thyroid function and TPO antibodies, multivariable linear regression models including relevant confounders were used. RESULTS There was no association of DAP metabolites with maternal TSH, FT4, TT4 or TPOAb concentrations during pregnancy. Similarly, there was no association of DAP metabolites with cord blood TSH or FT4. Results did not change when DAP concentrations were analyzed at individual time points or as mean gestational exposure. CONCLUSION Gestational OP pesticides exposure, as assessed by repeatedly measured urinary DAP metabolite concentrations in an urban population, was not associated with maternal or cord blood thyroid hormone concentrations. These findings do not support a mediating role for serum thyroid hormone availability in the relation of early life exposure to low levels of OP pesticides with child neurodevelopment. However, disruption of the thyroid system at tissue level cannot be excluded. In addition, this is one of the first studies on this subject and measurement error in DAP metabolites might have resulted in imprecise estimates. Future studies should use more urine samples to increase precision and should investigate specific OP pesticide metabolites.
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Affiliation(s)
- Tessa A Mulder
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Michiel A van den Dries
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tim I M Korevaar
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kelly K Ferguson
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA.
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Krysiak R, Kowalcze K, Okopień B. The effect of vitamin D on thyroid autoimmunity in euthyroid men with autoimmune thyroiditis and testosterone deficiency. Pharmacol Rep 2019; 71:798-803. [PMID: 31377561 DOI: 10.1016/j.pharep.2019.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/08/2019] [Accepted: 04/13/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Autoimmune (Hashimoto's thyroiditis) is characterized by a strong female preponderance, which may suggest that sex hormones have an impact on thyroid autoimmunity. The aim of this study was to investigate whether testosterone determines vitamin D action on thyroid antibody titers and thyroid function tests in men with autoimmune thyroiditis and low testosterone levels. METHODS The study included 36 men with testosterone deficiency, 17 of whom had been treated for at least 26 weeks with oral testosterone undecanoate (120 mg daily). Because of coexistent euthyroid Hashimoto's thyroiditis, all participants were then treated with vitamin D (100 μg daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin, free thyroid hormones, testosterone and 25-hydroxyvitamin D, as well as Jostel's thyrotropin index, SPINA-GT and SPINA-GD were assessed before vitamin D treatment and 26 weeks later. RESULTS With the exception of testosterone levels, there were no significant differences between both study groups in serum hormone levels, antibody titers and thyroid function tests. All participants completed the study. In addition to increasing 25-hydroxyvitamin D levels, vitamin D increased SPINA-GT and reduced thyroid peroxidase and thyroglobulin antibody titers. In testosterone-treated men, vitamin D increased testosterone levels. Vitamin D did not affect serum levels of thyrotropin, free thyroid hormones, Jostel's thyrotropin index and SPINA-GD. Treatment-induced changes in thyroid antibody titers and SPINA-GT were more pronounced in testosterone-treated than testosterone-naïve men. CONCLUSIONS The obtained results suggest that the beneficial effect on thyroid autoimmunity and thyroid secretory function is stronger in men receiving testosterone therapy.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Karolina Kowalcze
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Jasoliya M, Sacca F, Sahdeo S, Chedin F, Pane C, Brescia Morra V, Filla A, Pook M, Cortopassi G. Dimethyl fumarate dosing in humans increases frataxin expression: A potential therapy for Friedreich's Ataxia. PLoS One 2019; 14:e0217776. [PMID: 31158268 PMCID: PMC6546270 DOI: 10.1371/journal.pone.0217776] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/18/2019] [Indexed: 11/19/2022] Open
Abstract
Friedreich's Ataxia (FA) is an inherited neurodegenerative disorder resulting from decreased expression of the mitochondrial protein frataxin, for which there is no approved therapy. High throughput screening of clinically used drugs identified Dimethyl fumarate (DMF) as protective in FA patient cells. Here we demonstrate that DMF significantly increases frataxin gene (FXN) expression in FA cell model, FA mouse model and in DMF treated humans. DMF also rescues mitochondrial biogenesis deficiency in FA-patient derived cell model. We further examined the mechanism of DMF's frataxin induction in FA patient cells. It has been shown that transcription-inhibitory R-loops form at GAA expansion mutations, thus decreasing FXN expression. In FA patient cells, we demonstrate that DMF significantly increases transcription initiation. As a potential consequence, we observe significant reduction in both R-loop formation and transcriptional pausing thereby significantly increasing FXN expression. Lastly, DMF dosed Multiple Sclerosis (MS) patients showed significant increase in FXN expression by ~85%. Since inherited deficiency in FXN is the primary cause of FA, and DMF is demonstrated to increase FXN expression in humans, DMF could be considered for Friedreich's therapy.
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Affiliation(s)
- Mittal Jasoliya
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Francesco Sacca
- Department of Neurosciences, Odontostomatological and Reproductive Sciences, University Federico II, Naples, Italy
| | - Sunil Sahdeo
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Frederic Chedin
- Department of Molecular and Cellular Biology, University of California, Davis, California, United States of America
| | - Chiara Pane
- Department of Neurosciences, Odontostomatological and Reproductive Sciences, University Federico II, Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neurosciences, Odontostomatological and Reproductive Sciences, University Federico II, Naples, Italy
| | - Alessandro Filla
- Department of Neurosciences, Odontostomatological and Reproductive Sciences, University Federico II, Naples, Italy
| | - Mark Pook
- Department of Life Sciences, College of Health & Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Gino Cortopassi
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, United States of America
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Lynch DR, Hauser L, McCormick A, Wells M, Dong YN, McCormack S, Schadt K, Perlman S, Subramony SH, Mathews KD, Brocht A, Ball J, Perdok R, Grahn A, Vescio T, Sherman JW, Farmer JM. Randomized, double-blind, placebo-controlled study of interferon- γ 1b in Friedreich Ataxia. Ann Clin Transl Neurol 2019; 6:546-553. [PMID: 30911578 PMCID: PMC6414489 DOI: 10.1002/acn3.731] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 01/04/2023] Open
Abstract
Objective In vitro, in vivo, and open-label studies suggest that interferon gamma (IFN-γ 1b) may improve clinical features in Friedreich Ataxia through an increase in frataxin levels. The present study evaluates the efficacy and safety of IFN-γ 1b in the treatment of Friedreich Ataxia through a double-blind, multicenter, placebo-controlled trial. Methods Ninety-two subjects with FRDA between 10 and 25 years of age were enrolled. Subjects received either IFN-γ 1b or placebo for 6 months. The primary outcome measure was the modified Friedreich Ataxia Rating Scale (mFARS). Results No difference was noted between the groups after 6 months of treatment in the mFARS or secondary outcome measures. No change was noted in buccal cell or whole blood frataxin levels. However, during an open-label extension period, subjects had a more stable course than expected based on natural history data. Conclusions This study provides no direct evidence for a beneficial effect of IFN-γ1b in FRDA. The modest stabilization compared to natural history data leaves open the possibility that longer studies may demonstrate benefit.
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Affiliation(s)
- David R. Lynch
- Division of NeurologyChildren's Hospital of Philadelphia502 Abramson Research Center, 3615 Civic Center BlvdPhiladelphiaPennsylvania19104‐4318
| | - Lauren Hauser
- Division of NeurologyChildren's Hospital of Philadelphia502 Abramson Research Center, 3615 Civic Center BlvdPhiladelphiaPennsylvania19104‐4318
| | - Ashley McCormick
- Division of NeurologyChildren's Hospital of Philadelphia502 Abramson Research Center, 3615 Civic Center BlvdPhiladelphiaPennsylvania19104‐4318
| | - McKenzie Wells
- Division of NeurologyChildren's Hospital of Philadelphia502 Abramson Research Center, 3615 Civic Center BlvdPhiladelphiaPennsylvania19104‐4318
| | - Yi Na Dong
- Division of NeurologyChildren's Hospital of Philadelphia502 Abramson Research Center, 3615 Civic Center BlvdPhiladelphiaPennsylvania19104‐4318
| | - Shana McCormack
- Division of Endocrinology & DiabetesChildren's Hospital of PhiladelphiaPhiladelphia19104
| | - Kim Schadt
- Division of NeurologyChildren's Hospital of Philadelphia502 Abramson Research Center, 3615 Civic Center BlvdPhiladelphiaPennsylvania19104‐4318
| | - Susan Perlman
- Department of NeurologyUniversity of California Los AngelesBox 956975, 1‐167 RNRCLos AngelesCalifornia90095
| | - Sub H. Subramony
- Department of NeurologyUniversity of FloridaRoom L3‐100, McKnight Brain Institute, 1149 Newell DriveGainesvilleFlorida32611
| | - Katherine D. Mathews
- Department of Pediatrics and NeurologyUniversity of Iowa Carver College of MedicineIowa CityIowa
| | - Alicia Brocht
- Department of NeurologyUniversity of RochesterRochesterNew York14620
| | - Julie Ball
- Horizon Pharma, Inc.Lake ForestIllinois60045
| | | | - Amy Grahn
- Horizon Pharma, Inc.Lake ForestIllinois60045
| | - Tom Vescio
- Horizon Pharma, Inc.Lake ForestIllinois60045
| | | | - Jennifer M. Farmer
- Friedreich's Ataxia Research Alliance533 W Uwchlan AveDowningtownPennsylvania19335
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Guo L, Wang Q, Weng L, Hauser LA, Strawser CJ, Mesaros C, Lynch DR, Blair IA. Characterization of a new N-terminally acetylated extra-mitochondrial isoform of frataxin in human erythrocytes. Sci Rep 2018; 8:17043. [PMID: 30451920 PMCID: PMC6242848 DOI: 10.1038/s41598-018-35346-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/02/2018] [Indexed: 01/18/2023] Open
Abstract
Frataxin is a highly conserved protein encoded by the frataxin (FXN) gene. The full-length 210-amino acid form of protein frataxin (1-210; isoform A) expressed in the cytosol of cells rapidly translocates to the mitochondria, where it is converted to the mature form (81-210) by mitochondrial processing peptidase. Mature frataxin (81-210) is a critically important protein because it facilitates the assembly of mitochondrial iron-sulfur cluster protein complexes such as aconitase, lipoate synthase, and succinate dehydrogenases. Decreased expression of frataxin protein is responsible for the devastating rare genetic disease of Friedreich's ataxia. The mitochondrial form of frataxin has long been thought to be present in erythrocytes even though paradoxically, erythrocytes lack mitochondria. We have discovered that erythrocyte frataxin is in fact a novel isoform of frataxin (isoform E) with 135-amino acids and an N-terminally acetylated methionine residue. There is three times as much isoform E in erythrocytes (20.9 ± 6.4 ng/mL) from the whole blood of healthy volunteers (n = 10) when compared with the mature mitochondrial frataxin present in other blood cells (7.1 ± 1.0 ng/mL). Isoform E lacks a mitochondrial targeting sequence and so is distributed to both cytosol and the nucleus when expressed in cultured cells. When extra-mitochondrial frataxin isoform E is expressed in HEK 293 cells, it is converted to a shorter isoform identical to the mature frataxin found in mitochondria, which raises the possibility that it is involved in disease etiology. The ability to specifically quantify extra-mitochondrial and mitochondrial isoforms of frataxin in whole blood will make it possible to readily follow the natural history of diseases such as Friedreich's ataxia and monitor the efficacy of therapeutic interventions.
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Affiliation(s)
- Lili Guo
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States
| | - Qingqing Wang
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States
| | - Liwei Weng
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Lauren A Hauser
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States
- Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
- Departments of Pediatrics and Neurology Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Cassandra J Strawser
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States
- Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
- Departments of Pediatrics and Neurology Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Clementina Mesaros
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States
| | - David R Lynch
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States
- Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
- Departments of Pediatrics and Neurology Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Ian A Blair
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States.
- Penn/CHOP Center of Excellence in Friedreich's ataxia, Philadelphia, PA, 19104, United States.
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11
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Nishino S, Kodaka T, Sawada Y, Goka T, Gotoh Y, Tsunemine H, Takahashi T. Marked rebound thrombocytosis in response to glucocorticoids in a patient with acquired amegakaryocytic thrombocytopenia. J Clin Exp Hematop 2018; 58:166-170. [PMID: 30416171 PMCID: PMC6407476 DOI: 10.3960/jslrt.18016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Acquired amegakaryocytic thrombocytopenia (AATP) is a rare disease characterized by
thrombocytopenia and the disappearance of marrow megakaryocytes. A 43-year-old man was
admitted because of thrombocytopenia of 1.0×109/L. Bone marrow aspirate
demonstrated normal hematopoiesis lacking megakaryocytes, and AATP was diagnosed. The
serum concentration of thrombopoietin (TPO) was high (7.72 fmol/mL). Prednisolone (PSL) at
60 mg/day was started and the platelet count recovered to 1,335×109/L; however,
excessive megakaryocytopoiesis and subsequent decline in platelet count were noted 14 days
later. At the peak platelet count, the TPO remained at 3.79 fmol/mL and returned to a
normal level of 0.40 fmol/mL during the period of normal platelet count after PSL
tapering. The marked thrombocytosis in response to prednisolone may have been caused by
the high TPO after the resolution of suppressed megakaryopoiesis. Marked rebound
thrombocytosis beyond 1,000×109/L after successful PSL treatment for AATP has
not been previously reported.
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12
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Krysiak R, Szkróbka W, Okopień B. The effect of vitamin D and selenomethionine on thyroid antibody titers, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in men with Hashimoto's thyroiditis: A pilot study. Pharmacol Rep 2018; 71:243-247. [PMID: 30818086 DOI: 10.1016/j.pharep.2018.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/22/2018] [Accepted: 10/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Both selenium and vitamin D were found to reduce thyroid antibody titers in women with Hashimoto's thyroiditis. METHODS The study enrolled 37 young drug-naïve euthyroid men with autoimmune thyroiditis, who were treated for 6 months with either exogenous vitamin D (group A, n = 20) or selenomethionine (group B, n = 17). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin and free thyroid hormones, serum levels of 25-hydroxyvitamin D, as well Jostel's thyrotropin, the SPINA-GT and the SPINA-GD indices were determined at the beginning and at the end of the study. RESULTS At baseline, there were no differences between the study groups. Both vitamin D and selenomethionine reduced antibody titers and increased the SPINA-GT index. Only selenomethionine affected the SPINA-GD index, while only vitamin D increased 25-hydroxyvitamin D levels. Neither selenomethionine nor vitamin D significantly affected thyrotropin and free thyroid hormone levels. The effect of vitamin D on antibody titers correlated with baseline and treatment-induced changes in serum levels of 25-hydroxivitamin D. CONCLUSIONS Both vitamin D and selenomethionine have a beneficial effect on thyroid autoimmunity in drug-naïve men with Hashimoto's thyroiditis.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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13
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Guo L, Wang Q, Weng L, Hauser LA, Strawser CJ, Rocha AG, Dancis A, Mesaros C, Lynch DR, Blair IA. Liquid Chromatography-High Resolution Mass Spectrometry Analysis of Platelet Frataxin as a Protein Biomarker for the Rare Disease Friedreich's Ataxia. Anal Chem 2018; 90:2216-2223. [PMID: 29272104 PMCID: PMC5817373 DOI: 10.1021/acs.analchem.7b04590] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Friedreich's ataxia (FA) is an autosomal recessive disease caused by an intronic GAA triplet expansion in the FXN gene, leading to reduced expression of the mitochondrial protein frataxin. FA is estimated to affect 1 in 50 000 with a mean age of death in the fourth decade of life. There are no approved treatments for FA, although experimental approaches, which involve up-regulation or replacement of frataxin protein, are being tested. Frataxin is undetectable in serum or plasma, and whole blood cannot be used because it is present in long-lived erythrocytes. Therefore, an assay was developed for analyzing frataxin in platelets, which have a half-life of 10 days. The assay is based on stable isotope dilution immunopurification two-dimensional nano-ultra high performance liquid chromatography/parallel reaction monitoring/mass spectrometry. The lower limit of quantification was 0.078 pg frataxin/μg protein, and the assay had 100% sensitivity and specificity for discriminating between controls and FA cases. The mean levels of control and FA platelet frataxin were 9.4 ± 2.6 and 2.4 ± 0.6 pg/μg protein, respectively. The assay should make it possible to rigorously monitor the effects of therapeutic interventions on frataxin expression in this devastating disease.
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Affiliation(s)
- Lili Guo
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
| | - Qingqing Wang
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
| | - Liwei Weng
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Lauren A. Hauser
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
- Departments of Pediatrics and Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, United States
- Departments of Pediatrics and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Cassandra J. Strawser
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
- Departments of Pediatrics and Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, United States
- Departments of Pediatrics and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Agostinho G. Rocha
- Department of Medicine, Division of Hematology-Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Andrew Dancis
- Department of Medicine, Division of Hematology-Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Clementina Mesaros
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
| | - David R. Lynch
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
- Departments of Pediatrics and Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, United States
- Departments of Pediatrics and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Ian A. Blair
- Penn SRP Center and Center of Excellence in Environmental Toxicology Center, Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Penn/CHOP Center of Excellence in Friedreich’s Ataxia, Philadelphia, Pennsylvania 19104, United States
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14
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Korevaar TIM, Pop VJ, Chaker L, Goddijn M, de Rijke YB, Bisschop PH, Broeren MA, Jaddoe VWV, Medici M, Visser TJ, Steegers EAP, Vrijkotte TG, Peeters RP. Dose Dependency and a Functional Cutoff for TPO-Antibody Positivity During Pregnancy. J Clin Endocrinol Metab 2018; 103:778-789. [PMID: 29240902 DOI: 10.1210/jc.2017-01560] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/07/2017] [Indexed: 02/13/2023]
Abstract
OBJECTIVE To investigate a dose dependency of thyroperoxidase antibody (TPOAb) concentrations in relation to thyroid function and premature delivery and define a population-based, pregnancy-specific, functional cutoff for TPOAb positivity. DESIGN Individual participant meta-analysis of three prospective birth cohorts: the Amsterdam Born Children and their Development study, and the Holistic Approach to Pregnancy. SETTING Population-based studies in the Netherlands (2002 to 2014). PARTICIPANTS A total of 11,212 pregnant women (<20 weeks' gestation). MAIN OUTCOME MEASURES Thyrotropin (TSH) and FT4 concentrations, premature delivery. RESULTS In all cohorts, there was a dose-dependent positive association of TPOAb concentrations with TSH concentrations, as well as a dose-dependent negative association with FT4 concentrations during early pregnancy (all P < 0.0001). There was a dose-dependent association of TPOAb concentrations with the risk of premature delivery, which was also modified by TSH concentrations. Women with TPOAb concentrations from the 92nd percentile upward had a higher TSH and a higher risk of a TSH >2.5 mU/L (range, 19.4% to 51.3%). Stratified analyses showed that women with TPOAb concentrations below manufacturer cutoffs already had a higher risk of premature delivery, especially when TSH concentrations were high or in the high-normal range. CONCLUSIONS This study demonstrated a dose-dependent relationship between TPOAbs and thyroid function as well as the risk of premature delivery. Furthermore, our results indicate that the currently used cutoffs for TPOAb positivity may be too high. Furthermore, the use of a population-based cutoff for TPOAbs may identify women with a clinically relevant extent of thyroid autoimmunity and a higher risk of premature delivery but that would not be considered TPOAb positive or eligible for treatment otherwise.
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Affiliation(s)
- Tim I M Korevaar
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, the Netherlands
- Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Victor J Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Layal Chaker
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, the Netherlands
- Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Mariette Goddijn
- Department of Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Yolanda B de Rijke
- Sophia Children's Hospital, Rotterdam, the Netherlands
- Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter H Bisschop
- Department of Endocrinology, Academic Medical Center, Amsterdam, the Netherlands
| | - Maarten A Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
- Sophia Children's Hospital, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marco Medici
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, the Netherlands
- Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Theo J Visser
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, the Netherlands
- Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Sophia Children's Hospital, Rotterdam, the Netherlands
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Tanja G Vrijkotte
- Department of Public Health, Academic Medical Center, Amsterdam, the Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, the Netherlands
- Sophia Children's Hospital, Rotterdam, the Netherlands
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15
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Leonardi A, Penta L, Cofini M, Lanciotti L, Principi N, Esposito S. Pericardial Effusion as a Presenting Symptom of Hashimoto Thyroiditis: A Case Report. Int J Environ Res Public Health 2017; 14:ijerph14121576. [PMID: 29240719 PMCID: PMC5750994 DOI: 10.3390/ijerph14121576] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/06/2017] [Accepted: 12/09/2017] [Indexed: 11/16/2022]
Abstract
Background: Hashimoto thyroiditis (HT) is the most frequent cause of acquired hypothyroidism in paediatrics. HT is usually diagnosed in older children and adolescents, mainly in females and is rare in infants and toddlers with cardiac involvement, including pericardial effusion, that can be found in 10% to 30% of adult HT cases. In this paper, a child with HT and pericardial effusion as the most important sign of HT is described. Case presentation: A four-year-old male child suffering for a few months from recurrent abdominal pain sometimes associated with vomiting underwent an abdominal ultrasound scan outside the hospital. This led to the identification of a significant pericardial effusion. At admission, his family history revealed that both his mother and maternal grandmother suffered from HT and that both were treated with l-thyroxine (LT4). The clinical examination did not reveal any pathological signs other than a palpable thyroid. His weight was 21 kg (78th percentile), his height was 101.8 cm (12th percentile) and his body max index (BMI) was 20.26 (96th percentile). On a chest radiograph, his heart had a globular appearance and the lung fields were normal. An echocardiography confirmed and determined the effusion amount (max, 23 mm; 600 mL) with light impairment of the heart kinetics. The ECG showed sinus bradycardia with a normal ST tract. Based on the blood test results, an infectious cause of the pericardial fluid excess was considered unlikely. Thyroid function testing revealed very high thyrotropin (TSH, 487 μIU/mL; normal range, 0.340-5.600 μIU/mL) and low serum-free thyroxine (fT4, 0.04 ng/dL; normal range, 0.54-1.24 ng/dL) levels. High thyroid peroxidase antibody titres in the blood were evidenced (>1500 UI/L; normal values, 0.0-9.0 UI/L). The thyroid ultrasound was consistent with thyroiditis. HT was diagnosed, and LT4 replacement therapy with levothyroxine sodium 1.78 µg/kg/die was initiated, with a gradual increase of the administered dose. The treatment was successful because a complete regression of the effusion after one month was evidenced, with a substantial modification towards normality of the thyroid function tests. One year later, the substitutive therapy led to complete normalization of the thyroid function indexes. A slight reduction of weight (BMI, 17.60 for age) and an increase of the velocity of height growth were evidenced. Conclusions: When fluid is identified in the pericardial space and pericarditis of unknown origin is diagnosed, the thyroid function should be immediately evaluated to prescribe substitutive hormonal therapy if necessary and thereby avoid overt hypothyroidism development and the risk of cardiac tamponade.
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Affiliation(s)
- Alberto Leonardi
- Paediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia, Italy.
| | - Laura Penta
- Paediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia, Italy.
| | - Marta Cofini
- Paediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia, Italy.
| | - Lucia Lanciotti
- Paediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia, Italy.
| | | | - Susanna Esposito
- Paediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06132 Perugia, Italy.
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16
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Korevaar TIM, Steegers EAP, Pop VJ, Broeren MA, Chaker L, de Rijke YB, Jaddoe VWV, Medici M, Visser TJ, Tiemeier H, Peeters RP. Thyroid Autoimmunity Impairs the Thyroidal Response to Human Chorionic Gonadotropin: Two Population-Based Prospective Cohort Studies. J Clin Endocrinol Metab 2017; 102:69-77. [PMID: 27754809 DOI: 10.1210/jc.2016-2942] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/13/2016] [Indexed: 11/19/2022]
Abstract
CONTEXT Thyroperoxidase antibody (TPOAb) positivity is the main risk factor for thyroid dysfunction during pregnancy and is consistently associated with premature delivery. However, the underlying mechanism is currently unknown. We hypothesized that TPOAb positivity may interfere with gestational thyroid stimulation induced by the pregnancy hormone human chorionic gonadotropin (hCG). DESIGN, SETTING, AND PARTICIPANTS Thyrotropin (TSH), free thyroxine (FT4), TPOAbs, and/or hCG concentrations were measured in early and late pregnancy of 7587 pregnant women from 2 Dutch population-based prospective cohorts (n = 5924, Generation R study; n = 1663, Holistic Approach to Pregnancy and the First Postpartum Year study). INTERVENTIONS None. MAIN OUTCOME MEASURE(S) Thyroidal response to hCG stimulation, premature delivery. RESULTS In TPOAb-negative women, hCG was positively associated with FT4 and negatively with TSH in both cohorts (P < 0.0001). In contrast, in TPOAb-positive women, hCG was not associated with FT4 or TSH in either cohort (all P > 0.40; P for interaction TPOAb positive vs negative ≤ 0.05). Overall, TPOAb positivity was associated with a 1.7-fold higher risk of premature delivery. TPOAb-positive women with an adequate response of FT4 to hCG (high FT4 concentration with high hCG concentration) did not have a higher risk of premature delivery. In contrast, TPOAb-positive women with an inadequate FT4 response to hCG (low FT4 concentration with high hCG concentration) had a 2.2- to 2.8-fold higher risk of premature delivery. CONCLUSION TPOAb-positive women display an impaired thyroidal response to hCG and this may explain the higher risk of premature delivery in these women. This abnormal response in TPOAb-positive women might suggest that these women require a different treatment approach than TPOAb-negative women.
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Affiliation(s)
- Tim I M Korevaar
- The Generation R Study Group, and Departments of
- Internal Medicine
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Victor J Pop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg 5000 LE, The Netherlands; and
| | - Maarten A Broeren
- Laboratory of Clinical Chemistry and Hematology, Máxima Medical Centre, Veldhoven, De Run, 4600, The Netherlands
| | - Layal Chaker
- Internal Medicine
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Vincent W V Jaddoe
- The Generation R Study Group, and Departments of
- Pediatrics
- Epidemiology, and
| | - Marco Medici
- The Generation R Study Group, and Departments of
- Internal Medicine
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Theo J Visser
- Internal Medicine
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Epidemiology, and
- Child and Adolescent Psychiatry, Erasmus Medical Center and/or Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Robin P Peeters
- Internal Medicine
- Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
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17
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Ehlers M, Jordan AL, Feldkamp J, Fritzen R, Quadbeck B, Haase M, Allelein S, Schmid C, Schott M. Anti-Thyroperoxidase Antibody Levels >500 IU/ml Indicate a Moderately Increased Risk for Developing Hypothyroidism in Autoimmune Thyroiditis. Horm Metab Res 2016; 48:623-629. [PMID: 27607246 DOI: 10.1055/s-0042-112815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Autoimmune Thyroiditis (AIT) is the most common autoimmune disease, which is characterized by cellular and humoral immunity leading to thyroid destruction. The impact of the humoral immunity on the risk to develop hypothyroidism has not exactly been defined yet. The aim of the present study was to investigate the association between thyroid antibody levels and the risk for developing hypothyroidism. In this retrospective study, 335 untreated AIT patients were enrolled. Anti-thyroperoxidase (TPO) antibodies, anti-thyroglobulin (Tg) antibodies (Abs), and the TSH level were measured. Patients with TPO-Ab levels>500 IU/ml showed a moderately increased risk of having elevated TSH levels [p=0.0023; relative risk (95% confidence interval): 1.343 (1.108-1.627)] compared to those below this threshold. AIT patients with TPO- or Tg-Abs<100 IU/ml and between 100-500 IU/ml had no significantly different TSH levels. Presence of Tg-Abs alone or in combination with TPO-Abs did not help to increase the sensitivity to identify patients at risk. Long term follow-up of AIT patients with high TPO-Abs level (>500 IU/ml) showed an increase of TSH levels (mean: 0.5 mIU/l; range: 2.52±2.73 to 3.02±3.05 mIU/l; p=0.0420). Still, these patients remained euthyroid. Our data indicate largely elevated levels of TPO-Abs being associated with a moderately increased risk of developing hypothyroidism.
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Affiliation(s)
- M Ehlers
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - A-L Jordan
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - J Feldkamp
- Department for Endocrinology and Diabetes, Municipal Hospital Bielefeld, Bielefeld, Germany
| | - R Fritzen
- Outpatient Clinic for Endocrinology, Aachener Platz, Duesseldorf, Germany
| | - B Quadbeck
- Outpatient Clinic for Endocrinology, Duesseldorf, Germany
| | - M Haase
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - S Allelein
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - C Schmid
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - M Schott
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
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18
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Dantham S, Srivastava AK, Gulati S, Rajeswari MR. Plasma circulating cell-free mitochondrial DNA in the assessment of Friedreich's ataxia. J Neurol Sci 2016; 365:82-8. [PMID: 27206881 DOI: 10.1016/j.jns.2016.04.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/14/2016] [Accepted: 04/11/2016] [Indexed: 12/11/2022]
Abstract
Friedreich's ataxia (FRDA) is one of the most devastating childhood onset neurodegenerative disease affecting multiple organs in the course of progression. FRDA is associated with mitochondrial dysfunction due to deficit in a nuclear encoded mitochondrial protein, frataxin. Identification of disease-specific biomarker for monitoring the severity remains to be a challenging topic. This study was aimed to identify whether circulating cell-free nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) in blood plasma can be a potential biomarker for FRDA. Clinical information was assessed using International Cooperative Ataxia Rating Scale and the disease was confirmed using Long-range PCR for GAA repeat expansion within the gene encoding frataxin. The frataxin expression was measured using Western blot. Plasma nDNA and mtDNA levels were quantified by Multiplex real-time PCR. The major observation is that the levels of nDNA found to be increased, whereas mtDNA levels were reduced significantly in the plasma of FRDA patients (n=21) as compared to healthy controls (n=21). Further, plasma mtDNA levels showed high sensitivity (90%) and specificity (76%) in distinguishing from healthy controls with optimal cutoff indicated at 4.1×10(5)GE/mL. Interestingly, a small group of follow-up patients (n=9) on intervention with, a nutrient supplement, omega-3 fatty acid (a known enhancer of mitochondrial metabolism) displayed a significant improvement in the levels of plasma mtDNA, supporting our hypothesis that plasma mtDNA can be a potential monitoring or prognosis biomarker for FRDA.
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Affiliation(s)
- Subrahamanyam Dantham
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
| | - Achal K Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
| | - Sheffali Gulati
- Paediatrics Neurology, All India Institute of Medical Sciences, New Delhi, India.
| | - Moganty R Rajeswari
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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Abrahao A, Pedroso JL, de Carvalho Aguiar PM, Barsottini OGP. Gene Expression Profile in Peripheral Blood Cells of Friedreich Ataxia Patients. Cerebellum 2016; 15:306-13. [PMID: 26170003 DOI: 10.1007/s12311-015-0700-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Friedreich ataxia (FRDA) is the most common autosomal recessive ataxia characterized by a combination of neurological involvement, cardiomyopathy, and skeletal and glucose metabolism disturbances. FRDA is caused by mutations in FXN gene that results in reduction of mRNA and protein levels of frataxin. Previous microarray and real-time quantitative PCR (qPCR) studies showed that the downregulation of FXN is associated with a complex gene expression profile. However, these studies showed a wide variability in the subset of genes with altered expression among tissues and models. Genes differentially expressed in peripheral blood cells (PBC) could potentially help in the understanding of FRDA pathophysiology and also function as reliable disease biomarkers obtained from an easily accessible tissue, which could have implications in clinical practice. This study aimed to validate by qPCR the expression of 26 genes, revealed as differentially expressed by other studies, using peripheral blood cells (PBC) of 11 FRDA patients compared to 11 healthy controls. We found a robust downregulation of FXN, but no statistically significant differences were found between FRDA and controls for the remaining genes. Except for FXN, our study did not find a differential gene expression profile in PBC of FRDA patients and a reliable gene expression profile biomarker in a clinical relevant and noninvasive tissue remains unclear.
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Affiliation(s)
- Agessandro Abrahao
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Jose Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Patricia Maria de Carvalho Aguiar
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Division of Movement Disorders, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo - UNIFESP, Rua Pedro de Toledo 650, Vila Clementino, São Paulo, SP, 04039-002, Brazil.
| | - Orlando Graziani Povoas Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Marcotulli C, Fortuni S, Arcuri G, Tomassini B, Leonardi L, Pierelli F, Testi R, Casali C. GIFT-1, a phase IIa clinical trial to test the safety and efficacy of IFNγ administration in FRDA patients. Neurol Sci 2016; 37:361-4. [PMID: 26621361 DOI: 10.1007/s10072-015-2427-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/18/2015] [Indexed: 11/28/2022]
Abstract
Friedreich's ataxia is an autosomal recessive progressive degenerative disorder caused by deficiency of the protein frataxin. The most common genetic cause is a homozygotic expansion of GAA triplets within intron 1 of the frataxin gene leading to impaired transcription. Preclinical in vivo and in vitro studies have shown that interferon gamma (IFNγ) is able to up-regulate the expression of frataxin gene in multiple cell types. We designed a phase IIa clinical trial, the first in Italy, aimed at assessing both safety and tolerability of IFNγ in Friedreich's patients and ability to increase frataxin levels in peripheral blood mononuclear cells. Nine patients (6 female and 3 males aged 21-38 years) with genetically confirmed disease were given 3 subcutaneous escalating doses (100, 150 and 200 μg) of IFNγ (human recombinant interferon 1 b gamma, trade name IMUKIN(®)), over 4 weeks. The primary end-point was the assessment of the safety and tolerability of IFNγ by means of standard clinical and hematological criteria. The secondary end-point was the detection of changes of frataxin levels in peripheral blood mononuclear cells after each single escalating dose of the drug. IFNγ was generally well tolerated, the main adverse event was hyperthermia/fever. Although, increases in frataxin levels could be detected in a minority of patients, these changes were not significant. A large phase III multicenter, randomized clinical trial with IFNγ in Friedreich's ataxia patients is currently ongoing. This study is expected to conclusively address the clinical efficacy of IFNγ therapy in patients with Friedreich's ataxia.
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Affiliation(s)
- Christian Marcotulli
- Department of Medical Surgical Sciences and Biotechnologies, Polo Pontino-University of Rome "Sapienza", V. dell'Università 30, 00185, Rome, Italy.
| | - Silvia Fortuni
- Laboratory of Immunology and Signal Transduction, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Gaetano Arcuri
- Laboratory of Immunology and Signal Transduction, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Barbara Tomassini
- Laboratory of Immunology and Signal Transduction, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Leonardi
- Department of Medical Surgical Sciences and Biotechnologies, Polo Pontino-University of Rome "Sapienza", V. dell'Università 30, 00185, Rome, Italy
| | | | - Roberto Testi
- Laboratory of Immunology and Signal Transduction, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Carlo Casali
- Department of Medical Surgical Sciences and Biotechnologies, Polo Pontino-University of Rome "Sapienza", V. dell'Università 30, 00185, Rome, Italy
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Bjergved L, Carlé A, Jørgensen T, Perrild H, Laurberg P, Krejbjerg A, Ovesen L, Bülow Pedersen I, Rasmussen LB, Knudsen N. Parity and 11-Year Serum Thyrotropin and Thyroid Autoantibody Change: A Longitudinal Population-Based Study. Thyroid 2016; 26:203-11. [PMID: 26711373 DOI: 10.1089/thy.2014.0279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND A role for female reproductive factors in the pathogenesis of thyroid autoimmunity has been suggested. This study investigated the prospective association between parity, abortion, use of oral contraceptive pill (OCP), and use of hormone replacement therapy (HRT), and 11-year change in serum thyrotropin (TSH), as well as change in thyroid peroxidase autoantibody (TPOAb) status. METHODS A random sample of 4649 people aged 18-65 years participated in a population-based study in the period 1997-1998. In the study presented here, 1749 non-pregnant women with no history of thyroid disease were included who participated in the 11-year follow-up examination in the period 2008-2010. Gynecological exposures were reported in a self-administered questionnaire at baseline and follow-up. TSH and TPOAb were measured at baseline and follow-up. Increased TPOAb status during follow-up was defined as a TPOAb below the assay cutoff (<30 kIU/L) at baseline and a TPOAb ≥30 kIU/L at follow-up. Multiple linear regression models were used, adjusted for age, smoking status, and urinary iodine excretion. RESULTS An inverse association was found between the number of years on HRT and the risk (odds ratio) of increased TPOAb status during follow-up (0.735 [confidence interval 0.558-0.968], p = 0.03). However, this association was not statistically significant when applying the Bonferroni adjusted significance level. The remaining reproductive factors showed no statistically significant association with risk of increased TPOAb during follow-up. Furthermore, parity, abortions, use of OCP, HRT use, age at menarche, and being pre- or postmenopausal were not significantly associated with 11-year TSH change. CONCLUSIONS No statistically significant association was found between the studied female reproductive measures and 11-year risk of TSH or TPO change. A possible protective role for HRT in the etiology of thyroid autoimmunity, however, deserves further research.
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Affiliation(s)
- Lena Bjergved
- 1 Research Centre for Prevention and Health , The Capital Region of Denmark, Glostrup, Denmark
- 2 Department of Endocrinology, Bispebjerg University Hospital , Copenhagen, Denmark
| | - Allan Carlé
- 3 Department of Endocrinology, Aalborg University Hospital , Aalborg, Denmark
| | - Torben Jørgensen
- 1 Research Centre for Prevention and Health , The Capital Region of Denmark, Glostrup, Denmark
- 4 Faculty of Health Sciences, University of Copenhagen , Copenhagen, Denmark
- 5 Faculty of Medicine, Aalborg University , Aalborg, Denmark
| | - Hans Perrild
- 2 Department of Endocrinology, Bispebjerg University Hospital , Copenhagen, Denmark
| | - Peter Laurberg
- 3 Department of Endocrinology, Aalborg University Hospital , Aalborg, Denmark
- 5 Faculty of Medicine, Aalborg University , Aalborg, Denmark
| | - Anne Krejbjerg
- 3 Department of Endocrinology, Aalborg University Hospital , Aalborg, Denmark
| | - Lars Ovesen
- 6 Department of Gastroenterology, Slagelse Hospital , Slagelse, Denmark
| | - Inge Bülow Pedersen
- 3 Department of Endocrinology, Aalborg University Hospital , Aalborg, Denmark
| | - Lone Banke Rasmussen
- 7 Department of Nutrition, National Food Institute, Technical University of Denmark , Søborg, Denmark
| | - Nils Knudsen
- 2 Department of Endocrinology, Bispebjerg University Hospital , Copenhagen, Denmark
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Wang B, Hawa MI, Rijsdijk FV, Fain PR, Paschou SA, Boehm BO, Steck AK, Snieder H, Leslie RDG. Heritability of thyroid peroxidase autoantibody levels in type 1 diabetes: evidence from discordant twin pairs. Diabetologia 2015; 58:2079-86. [PMID: 26070305 PMCID: PMC4886710 DOI: 10.1007/s00125-015-3664-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/20/2015] [Indexed: 01/22/2023]
Abstract
AIMS/HYPOTHESIS The discordance status of (autoimmune) type 1 diabetes within monozygotic twin pairs points to the importance of environmental factors. The aim of this study was to investigate whether the environmental events causing type 1 diabetes influence thyroid autoimmunity. METHODS Monozygotic and dizygotic twins discordant for type 1 diabetes from the UK and USA were tested for thyroid peroxidase autoantibodies (TPOA) by radioimmunoassay. Using quantitative genetic model fitting of a liability-threshold model we estimated the contribution of genetic (heritability) and environmental factors to TPOA. RESULTS TPOA positivity was higher in females than in males in both cohorts and was associated with later age at diagnosis in the UK and combined cohorts (p < 0.01). TPOA did not specifically segregate with type 1 diabetes in the twin pairs (p > 0.2 in all groups). The best-fitting models showed heritability (95% CI) estimates for TPOA of 63% (37%, 80%) for the UK and 80% (51%, 92%) for US twins, while the best-fitting meta-analysis model of the two twin cohorts combined included additive genetic and unique environmental factors with a heritability estimate of 69% (50%, 82%). CONCLUSIONS/INTERPRETATION Risk of thyroid autoimmunity, defined by TPOA, in the context of autoimmune diabetes is, substantially, genetically determined in discordant twin pairs. Environmental factors leading to type 1 diabetes were not the same as those involved with thyroid autoimmunity. It follows that it is as important to investigate for thyroid autoimmunity in relatives of type 1 diabetes patients as it is in the patients themselves.
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Affiliation(s)
- Bin Wang
- Department of Epidemiology, University of Groningen, University Medical Center, Groningen, the Netherlands
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China
| | - Mohammed I. Hawa
- Centre for Diabetes and Metabolic Medicine, The Blizard Institute, Queen Mary, University of London, London E1 2AT, UK
| | - Frühling V. Rijsdijk
- Institute of Psychiatry, Department of Psychosis Studies, King’s College London, London, UK
| | - Pamela R. Fain
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - Stavroula A. Paschou
- Centre for Diabetes and Metabolic Medicine, The Blizard Institute, Queen Mary, University of London, London E1 2AT, UK
| | - Bernhard O. Boehm
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore and Imperial College London, London, UK
- Department of Internal Medicine 1, Ulm University Medical Centre, Ulm, Germany
| | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center, Groningen, the Netherlands
| | - R. David G. Leslie
- Centre for Diabetes and Metabolic Medicine, The Blizard Institute, Queen Mary, University of London, London E1 2AT, UK
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Wang X, Osiman R, Ma F, Guo Y, Tuhuti H, Zhao H, Abudunaiyimu M, Jin X, Wang H, Xing S. [Changes of thyroid function, thyroid antibodies and urinary iodine among permanent residents of Urumqi in Xinjiang]. Zhonghua Liu Xing Bing Xue Za Zhi 2015; 36:811-814. [PMID: 26714533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To understand the rates of diagnosis on thyroid disease and the differences in the distribution of age groups among those permanent residents, to analyze the relationships among thyroid function, thyroid antibodies and urinary iodine. METHODS A cross-sectional survey was performed in 1 995 permanent residents in Urumqi, Xinjiang in May, 2013, Among them, 1 906 were healthy adults aged 18-84 age, with mean age as (46.3 ± 14.2) years and 30.4% of them were men. One time 10 ml random urine and blood samples were drown to examine urinary iodine (UI) thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), anti-thyroglobulin (TgAb) and anti-thyroid peroxidase (TPOAb). RESULTS 1) 213 residents were newly diagnosed as having thyroid dysfunction (11.2%, including 78.4% women), hyperthyroidism (clinical and subclinical hyperthyroidism) that accounted for 2.7%, hypothyroidism (clinical and subclinical hypothyroidism) was accounted for 8.5%. Positive rates of TgAb (23.2%), TPOAb (16.6%) were noticed. The median urinary iodine was 134.5 µg/L, with 32% of the subjects were having iodine deficiency, 58% having adequate iodine and another 10% as under excessive iodine. No differences were observed on urine iodine between thyroid dysfunction and euthyroidism or between subjects with positive and negative antibodies. 2) TSH appeared different among age-groups of 18-, 45- and over 60. TSH showed higher in women than in men, with P value as < 0.001. For people with euthyroidism, TSH level in the antibody positive group was significantly higher than the antibody negative group (P < 0.000 1). 3) For people over 60 of age, morbidity of hypothyroidism was significantly higher than those under 60 but with no differences related to hyperthyroidism or the antibody positive rate. CONCLUSION UI levels were not significantly related with thyroid function and thyroid antibodies among residents of Urumqi, women showed higher on thyroid dysfunction or the rate of positive antibody. In the antibody positive group, TSH levels were significantly higher than in the antibody negative group. Hypothyroidism was seen higher in the over 60-years-of-age population. Monitoring programs on thyroid function, thyroid antibodies and urinary iodine among people over 60-years-of-age, should be strengthened.
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Affiliation(s)
- Xinling Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Reziwan Osiman
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Fuhui Ma
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Yanying Guo
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China;
| | - Hemai Tuhuti
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Hongli Zhao
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Munila Abudunaiyimu
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Xiaoping Jin
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Huili Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
| | - Shuqing Xing
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, China
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Minchella PA, Donkor S, Owolabi O, Sutherland JS, McDermid JM. Complex anemia in tuberculosis: the need to consider causes and timing when designing interventions. Clin Infect Dis 2014; 60:764-72. [PMID: 25428413 DOI: 10.1093/cid/ciu945] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Anemia is common in tuberculosis, and multiple etiologies necessitate targeted interventions. The proportion of iron-responsive anemia due to iron deficiency compared with iron-unresponsive anemia due to impaired iron absorption/redistribution from tuberculosis-associated immune activation or inflammation is unknown. This impedes selection of safe and effective treatment and appropriate intervention timing. METHODS Baseline hemoglobin, ferritin, hepcidin, soluble transferrin receptor (sTfR), and transferrin were measured in 45 patients with confirmed pulmonary tuberculosis (cases), 47 tuberculin skin test (TST)-positive controls, and 39 TST-negative controls in The Gambia. Tuberculosis cases were additionally followed 2 and 6 months after tuberculosis treatment initiation. Mutually exclusive anemia categories based on iron biomarker concentrations were iron deficiency anemia (IDA), anemia of inflammation (AI), and multifactorial anemia (IDA+AI). RESULTS Anemia was more frequent in tuberculosis cases (67%) than in TST-positive (36%) or TST-negative (21%) controls. AI was the predominant anemia at tuberculosis diagnosis, declining from 36% to 8% after 6 months of treatment; however, a corresponding reduction was not evident for anemia with iron-responsive components (IDA, IDA+AI). Iron biomarkers discriminated between active tuberculosis and TST-positive or TST-negative controls, as well as between active untreated and treated tuberculosis. This was most noticeable for hepcidin, which decreased from a median of 84.0 ng/mL at diagnosis to 9.7 ng/mL after 2 months (P < .001). CONCLUSIONS Tuberculosis chemotherapy is associated with significant reductions in AI, but IDA and IDA+AI remain unresolved. Iron-based interventions are needed for IDA and IDA+AI, and monitoring of iron biomarkers reveals a window for intervention opening as early as 2 months into tuberculosis treatment.
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Affiliation(s)
- Peter A Minchella
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Simon Donkor
- Vaccinology Theme, Medical Research Council Unit, Fajara, The Gambia
| | - Olumuyiwa Owolabi
- Vaccinology Theme, Medical Research Council Unit, Fajara, The Gambia
| | | | - Joann M McDermid
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
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Nesheli HM, Esmailzadeh S, Haghshenas M, Bijani A, Moghaddams TG. Effect of late vs early clamping of the umbilical cord (on haemoglobin level) in full-term neonates. J PAK MED ASSOC 2014; 64:1303-1305. [PMID: 25831651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sixty term infants delivered vaginally were assigned randomly to one of the two management groups; early cord clamping (ECC) or delayed cord clamping (DCC). Six months after delivery, the children in both groups were called back for follow-up. Blood samples were obtained for measuring haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), serum iron (SI), transferrin saturation (TS) and serum ferritin (SF) levels. The mean Hb, HCT, SI and TS at 6 months were significantly higher in the DCC group (95% confidence interval (CI); p<0.001, p<0.001, p<0.024 and p<0.009). The mean SF at 6 months was also higher in the DCC group but it was not significant (p<0.071). Polycythaemia, jaundice and other undesirable side-effects of DCC were not seen.
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Abstract
BACKGROUND Friedreich ataxia (FRDA) is a neurodegenerative disease caused by mutations in the frataxin (FXN) gene, resulting in reduced expression of the mitochondrial protein frataxin. Improved understanding of the pathophysiology of the disease has led to a growing need for informative biomarkers to assess disease progression and response to therapeutic intervention. OBJECTIVE To evaluate the performance of frataxin measurements as a diagnostic tool using two different immunoassays. METHODS Clinical and demographic information was provided through an ongoing longitudinal natural history study on FRDA. Frataxin protein levels from multiple cell types in controls, carriers and FRDA patients were measured and compared using a lateral flow immunoassay and a Luminex xMAP-based immunoassay. Receiver operating characteristic curve analyses were then performed to evaluate the sensitivity, specificity, and positive and negative predictive values for each immunoassay. RESULTS For whole blood and buccal cells, analysing FRDA patients and carriers together in a cohort resulted in higher sensitivities and positive predictive values compared with analyzing controls and carriers together, with similar results between each tissue type. We then compared the usefulness of a lateral flow immunoassay with a multianalyte Luminex xMAP-based immunoassay, and showed that both assays demonstrate high positive predictive values with low rates of false negatives and false positives. CONCLUSIONS Frataxin measurements from peripheral tissues can be used to identify FRDA patients and carriers. While multiple cell types and assays may be useful for diagnostic purposes, each assay and cell type used has its advantages and disadvantages depending on study design and scope.
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Affiliation(s)
- Eric C Deutsch
- Department of Pharmacology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Devin Oglesbee
- Department of Laboratory Medicine and Pathology, Department of Molecular Genetics, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathaniel R Greeley
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - David R Lynch
- Department of Pharmacology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Liu Y, Lv Q, Gao J, Long L, Duan Z, Liang H, Shen T, Lu F. Coinfection with HIV-1 alleviates iron accumulation in patients with chronic hepatitis C virus infection. PLoS One 2014; 9:e98039. [PMID: 24927015 PMCID: PMC4057081 DOI: 10.1371/journal.pone.0098039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 04/27/2014] [Indexed: 12/20/2022] Open
Abstract
Most chronically-infected hepatitis C virus (HCV) patients have increased levels of iron in the liver. Iron overload reduces sustained responses to antiviral therapy, leading to more rapid progression to liver cirrhosis and the development of hepatocellular carcinoma. However, it is still unclear how HIV-1 infection affects iron status in patients chronically infected with HCV. The present study recruited 227 patients from a village in central China. These patients were either monoinfected with HCV (n = 129) or coinfected with HCV/HIV-1 (n = 98). Healthy controls (n = 84) were also recruited from the same village. Indicators of iron status, such as serum levels of iron, ferritin, and transferrin, total iron-binding capacity (TIBC), transferrin saturation (Tfs), and hepcidin, were analyzed and compared across the three groups. The results showed that serum levels of iron (p = 0.001) and ferritin (p = 0.009) and the Tfs (p = 0.002) were significantly higher in HCV-monoinfected patients than in the healthy controls; however, there were no differences in iron levels and Tfs between HCV/HIV-1 coinfected patients and healthy controls. Additionally, although serum hepcidin levels in HCV-monoinfected and HCV/HIV-1-coinfected patients were lower (p<0.001) than those in health controls, the levels in coinfected patients were higher (p = 0.025) than those in HCV-monoinfected patients. Serum iron and ferritin levels in HCV-monoinfected patients were positively correlated with serum ALT/AST. Serum transferrin levels were negatively correlated with ALT/AST levels. The levels of iron in the serum of coinfected patients with a CD4+T-cell count <500/µl were lower than those in patients with a CD4+T-cell count ≥500/µl, whereas serum hepcidin levels showed the opposite trend. Taken together, these results suggest that coinfection with HIV-1 alleviates iron accumulation caused by chronic HCV infection. Our study indicated that determining the status of serum iron and other iron-associated parameters will be helpful to understand the complexity of alternations in iron distribution in HCV/HIV-1-coinfected patients.
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Affiliation(s)
- Yuan Liu
- Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Quanjun Lv
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Jian Gao
- Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China
| | - Lu Long
- Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China
| | - Zhaojun Duan
- Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China
| | - Hua Liang
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Tao Shen
- Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China
- * E-mail:
| | - Fengmin Lu
- Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China
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Zubrikhina GN, Blinder VN, Matveyeva II. [The possibilities of modern automated clinical blood analysis in differentiated diagnostic of true and redistributing (functional) iron deficiency under anemic syndrome in oncologic patients]. Klin Lab Diagn 2014:21-25. [PMID: 25338459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The clinical blood analysis implemented at modern hematological analyzers can be used as a foundation for primary differentiated diagnostic of anemic syndrome related to true and functional iron deficiency in oncologic patients. The normocyte normochromic anemia with normal and higher level of hemoglobin of reticulocytes (RET-HE) testifies presence in higher degree of anemia of chronic diseases which is more often combined with higher content of serum ferritin (Ferr), lower level of soluble receptors of ferritin (sTfR) and production of erythropoietin (EPO) inadequate to anemia degree. The microcyte hypochromic anemia can be present both under iron-deficient anemia and under functional iron deficiency as a result of its blocking in macrophages under anemia of chronic diseases in oncologic patients. Hence the differentiated diagnostic of these states demands additional analysis of content of serum ferritin, soluble receptors of ferritin and production of erythropoietin.
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Potlukova E, Freiberger T, Limanova Z, Jiskra J, Telicka Z, Bartakova J, Springer D, Vitkova H, Trendelenburg M. Association between low levels of Mannan-binding lectin and markers of autoimmune thyroid disease in pregnancy. PLoS One 2013; 8:e81755. [PMID: 24339961 PMCID: PMC3858249 DOI: 10.1371/journal.pone.0081755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 10/16/2013] [Indexed: 01/22/2023] Open
Abstract
Functional deficiency of mannan-binding lectin (MBL) has been associated with adverse pregnancy outcome. Adverse events during pregnancy have also been described in women with autoimmune thyroid diseases (AITD), and thyroid hormones have been shown to influence serum levels of MBL. Therefore, the aim of this study was to analyse the impact of MBL-deficiency on the outcome of pregnancy in relation to the presence of AITD. Almost one year after delivery, we assessed serum MBL levels and MBL2-genotypes in 212 women positively screened for AITD in pregnancy. In 103 of these women, we could also measure MBL levels in frozen serum samples from the 9-12th gestational week, obtaining 96 pairs of MBL values (pregnancy vs. follow-up). As controls, 80 sera of pregnant women screened negatively for AITD were used. MBL2-genotyping was performed using multiplex PCR. Women with thyroid dysfunction and/or thyroid peroxidase antibodies (TPOAb) had lower MBL levels during pregnancy than controls, (3275 vs. 5000 ng/ml, p<0.05). The lowest levels were found in women with elevated thyroid-stimulating hormone (TSH) levels in the absence of TPOAb (2207 ng/ml; p<0.01 as compared to controls). MBL2 genotype distribution did not differ between subgroups. At a median follow-up period of 17 months (range: 3–78 months) after delivery, median MBL level had decreased further to 1923 ng/ml (p<0.0001) without significant changes in TSH. In an explorative survey, functional MBL-deficiency was neither linked to a history of spontaneous abortion, nor other obstetric complications, severe infections throughout life/pregnancy or antibiotics use in pregnancy. In conclusion, hypothyroidism during pregnancy is associated with decreased MBL levels, and the levels decreased further after delivery.
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Affiliation(s)
- Eliska Potlukova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Molecular Genetics Laboratory, Brno, Czech Republic, and Ceitec and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdenka Limanova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jan Jiskra
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Zdenek Telicka
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jana Bartakova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Drahomira Springer
- Institute of Clinical Biochemistry and Laboratory Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Hana Vitkova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Marten Trendelenburg
- Laboratory of Clinical Immunology, Department of Biomedicine, University Hospital Basel, Switzerland
- * E-mail:
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Oglesbee D, Kroll C, Gakh O, Deutsch EC, Lynch DR, Gavrilova R, Tortorelli S, Raymond K, Gavrilov D, Rinaldo P, Matern D, Isaya G. High-throughput immunoassay for the biochemical diagnosis of Friedreich ataxia in dried blood spots and whole blood. Clin Chem 2013; 59:1461-9. [PMID: 23838345 PMCID: PMC3914541 DOI: 10.1373/clinchem.2013.207472] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Friedreich ataxia (FRDA) is caused by reduced frataxin (FXN) concentrations. A clinical diagnosis is typically confirmed by DNA-based assays for GAA-repeat expansions or mutations in the FXN (frataxin) gene; however, these assays are not applicable to therapeutic monitoring and population screening. To facilitate the diagnosis and monitoring of FRDA patients, we developed an immunoassay for measuring FXN. METHODS Antibody pairs were used to capture FXN and an internal control protein, ceruloplasmin (CP), in 15 μL of whole blood (WB) or one 3-mm punch of a dried blood spot (DBS). Samples were assayed on a Luminex LX200 analyzer and validated according to standard criteria. RESULTS The mean recovery of FXN from WB and DBS samples was 99%. Intraassay and interassay imprecision (CV) values were 4.9%-13% and 9.8%-16%, respectively. The FXN limit of detection was 0.07 ng/mL, and the reportable range of concentrations was 2-200 ng/mL. Reference adult and pediatric FXN concentrations ranged from 15 to 82 ng/mL (median, 33 ng/mL) for DBS and WB. The FXN concentration range was 12-22 ng/mL (median, 15 ng/mL) for FRDA carriers and 1-26 ng/mL (median 5 ng/mL) for FRDA patients. Measurement of the FXN/CP ratio increased the ability to distinguish between patients, carriers, and the reference population. CONCLUSIONS This assay is applicable to the diagnosis and therapeutic monitoring of FRDA. This assay can measure FXN and the control protein CP in both WB and DBS specimens with minimal sample requirements, creating the potential for high-throughput population screening of FRDA.
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Affiliation(s)
- Devin Oglesbee
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
- Department of Medical Genetics, Mayo Clinic College of Medicine, Rochester, MN
| | - Charles Kroll
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
| | - Oleksandr Gakh
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, Rochester, MN
| | - Eric C. Deutsch
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
- Department of Pharmacology, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
| | - David R. Lynch
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
- Department of Pharmacology, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
| | - Ralitza Gavrilova
- Department of Medical Genetics, Mayo Clinic College of Medicine, Rochester, MN
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Silvia Tortorelli
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
| | - Kimiyo Raymond
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
| | - Dimitar Gavrilov
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Piero Rinaldo
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Dietrich Matern
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
- Department of Medical Genetics, Mayo Clinic College of Medicine, Rochester, MN
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Grazia Isaya
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, Rochester, MN
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN
- Mayo Clinic Children’s Center, Rochester, MN
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Rao PK, Reddy RV, Mapare SA, Nag VR, Gowtham K, Arora D. An investigation of blood hemogram and estimation of serum iron and protein levels in aggressive periodontitis patients: a clinic biochemical study. J Contemp Dent Pract 2013; 14:852-857. [PMID: 24685787 DOI: 10.5005/jp-journals-10024-1415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study is to investigate the blood hemogram and estimation of serum iron and proteins level in aggressive periodontitis patients. MATERIALS AND METHODS A total of 85 patients were selected and divided into two groups, 45 patients are with aggressive periodontitis and 40 patients are healthy. Periodontal parameters such as gingival infammation oral hygiene index, Russell's periodontal index and radiograph were taken. Total 10 ml blood was collected and sent for estimation of blood hemogram protein estimation and serum electrophoresis. RESULTS There was statistical signifcant difference observed in relation to gingival infammation oral hygiene hemoglobin and total iron binding capacity level between both the groups. CONCLUSION It has been concluded that periodontitis does not induce anemia like state, as the hematological and biochemical parameters were almost equally affected in periodontally healthy and periodontally diseased individuals, but some parameters showed statistical significant difference between the both groups. CLINICAL SIGNIFICANCE In the present study, the clinical periodontal parameters, red blood cell parameters and serum iron and ferritin levels were compared among control and test groups. It was found that the values of gingival infammation, oral hygiene and periodontal index, hemoglobulin level and total iron binding protein were statistically signifcant between the groups. However, the values of erythrocyte count, white blood cell count, serum iron and serum proteins, serum electrophoresis did not show any signifcant correlation.
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Affiliation(s)
- P Krishna Rao
- Professor and Head, Department of Periodontics, HSRSM Dental College and Hospital, Hingoli, Maharashtra, India, e-mail:
| | - R Vamshidhar Reddy
- Professor and Head, Department of Orthodontics, HSRSM Dental College and Hospital, Hingoli, Maharashtra, India
| | - Sagar Arjun Mapare
- Reader, Department of Orthodontics, HSRSM Dental College and Hospital, Hingoli, Maharashtra, India
| | - Venkat Ratna Nag
- Reader, Department of Prosthodontics, SB Patil Dental College, Bidar Karnataka, India
| | - K Gowtham
- Senior Lecturer, Department of Conservative Dentistry and Endodontics Malla Reddy Dental College, Hyderabad, Andhra Pradesh, India
| | - Dimple Arora
- Assistant Professor, Department of Physiology, CM Medical College Durg, Chhattisgarh, India
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Yang L, Wang C, Xiao F. [Effects of different zinc nutritional status on iron metabolism in rats]. Wei Sheng Yan Jiu 2013; 42:647-651. [PMID: 24024381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To study the effects of different zinc nutritional status on iron metabolism and explore the potential role of iron regulator protein 2 (IRP2) under conditions of zinc deficiency. METHODS Forty clean male SD rats were randomly divided into four groups according to the weight and every group included 10 rats. The rats were administrated normal iron and zinc control group (ZA group), normal iron and slight deficient group (ZD group), Paired fed group (PF group), normal iron and zinc excessive group (ZE group). Rats were sacrificed by sodium pentobarbital anesthesia after 8 weeks and serum, liver and spleen of the rats were collected. The serum zinc, serum iron, hemoglobin, serum transferrin receptor, serum ferritin, iron and zinc in the liver, iron and zinc in the spleen were determined. The level of IRP2 mRNA expression,liver transferring receptor (TfR) mRNA expression and ferritin (Fn) mRNA expression were measured using reverse transcription polymerase chain reaction (RT-PCR) method. RESULTS Compared with that of the control group, iron content both in the liver and spleen, and the concentration of serum iron in ZE group was significantly decreased (P < 0.05). Compared with the control group, zinc deficiency increased iron content in the liver and the concentration of serum transferrin receptor significantly (P < 0.05), while the concentration of serum iron was significantly decreased (P < 0.05). Compared with the control group, zinc deficiency increased the level of IRP2 mRNA and TfR mRNA expression in the liver significantly (P < 0.05). CONCLUSION Zinc may affect iron nutritional status by influencing absorption, storage and transportation of iron. Zinc deficiency influences iron homeostasis in cells through affecting the expression of IRP2 and the activity of IRP-RNA combination and then change the expressions of ferritin and transferrin mRNA.
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Affiliation(s)
- Li Yang
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin 150081, China.
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Gierach M, Gierach J, Skowrońska A, Rutkowska E, Spychalska M, Pujanek M, Junik R. Hashimoto's thyroiditis and carbohydrate metabolism disorders in patients hospitalised in the Department of Endocrinology and Diabetology of Ludwik Rydygier Collegium Medicum in Bydgoszcz between 2001 and 2010. Endokrynol Pol 2012; 63:14-17. [PMID: 22378092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Chronic lymphocytic thyroiditis, also known as Hashimoto's thyroiditis, is the most frequent type of thyroiditis. An average of 2% of the population have the disease. It occurs in all age groups, also in children. The main cause of the disease are autoimmune disorders, which results in incresed risk of suffering from type 1 diabetes. Fourthermore, during the course of Hashimoto's thyroiditis, hypothyroidism may cause carbohydrate metabolism disorders. Aim of our study was estimate disturbances of glycaemia in patients with recognized Hashimoto's thyroiditis, hospitalized in Endokrinology and Diabetology Depatment of Collegium Medicum University of Nicolaus Copernicus in Bydgoszcz in years 2001-2010. MATERIAL AND METHODS We examined 54 patients with the diagnosis of Hashimoto thyroiditis based on clinical picture and examination(autoantibodies anti-TPO and anti-Tg). RESULTS In the tested group with Hashimoto's thyroiditis, diabetes has been confirmed in 27.8% of the patients; impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT) occurred in 16.6%, whereas a normoglycaemia has been confirmed in 55.6% of the pacients. An average age of the patients with Hashimoto's thyroiditis and diabetes at the same time, was 53 years. The patients in which we confirmed the impaired fasting glycaemia or impaired glucose tolerance were on average 49.9 years old. An average age of the patients without any carbohydrate methabolism disorders was on average 43.1 years. CONCLUSIONS Carbohydrate metabolism disorders in the form of type 1 diabetes connected with an autoimmune process, as well as type 2 diabetes connected with the increase of the insulin resistance, occured in average of half of the patients with Hashimoto's thyroiditis.
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Affiliation(s)
- Marcin Gierach
- Department of Endocrinology and Diabetology of Ludwik Rydygier, Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus in Toruń, ul. M. Skłodowskiej-Curie 9, Bydgoszcz, Poland.
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Nachbauer W, Hering S, Seifert M, Steinkellner H, Sturm B, Scheiber-Mojdehkar B, Reindl M, Strasak A, Poewe W, Weiss G, Boesch S. Effects of erythropoietin on frataxin levels and mitochondrial function in Friedreich ataxia--a dose-response trial. Cerebellum 2011; 10:763-9. [PMID: 21597884 DOI: 10.1007/s12311-011-0287-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Friedreich ataxia (FRDA) is an autosomal recessive inherited neurodegenerative disorder leading to reduced expression of the mitochondrial protein frataxin. Previous studies showed frataxin upregulation in FRDA following treatment with recombinant human erythropoietin (rhuEPO). Dose-response interactions between frataxin and rhuEPO have not been studied until to date. We administered escalating rhuEPO single doses (5,000, 10,000 and 30,000 IU) in monthly intervals to five adult FRDA patients. Measurements of frataxin, serum erythropoietin levels, iron metabolism and mitochondrial function were carried out. Clinical outcome was assessed using the "Scale for the assessment and rating of ataxia". We found maximal erythropoietin serum concentrations 24 h after rhuEPO application which is comparable to healthy subjects. Frataxin levels increased significantly over 3 months, while ataxia rating did not reveal clinical improvement. All FRDA patients had considerable ferritin decrease. NADH/NAD ratio, an indicator of mitochondrial function, increased following rhuEPO treatment. In addition to frataxin upregulation in response to continuous low-dose rhuEPO application shown in previous studies, our results indicate for a long-lasting frataxin increase after single high-dose rhuEPO administration. To detect frataxin-derived neuroprotective effects resulting in clinically relevant improvement, well-designed studies with extended time frame are required.
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Affiliation(s)
- Wolfgang Nachbauer
- Department of Neurology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria
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Smorkalova EV, Aznabaeva LF, Nikulicheva VI, Safuanova GS, Chepurnaia AN. [The characteristics of iron metabolism under iron-deficiency anemia and chronic disorders anemia]. Klin Lab Diagn 2011:30-32. [PMID: 21899115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The study investigated the issues of iron metabolism under iron-deficiency anemia and chronic disorders anemia and dependencies of production of IL-1? and sICAM-1 immunoinflammatory markers from degree of severity and duration of anemia. The study data indicates that under iron-deficiency anemia lactoferrin and sICAM-1 are the negative regulators of hemopoiesis. The inhibition of transferrin expression by the proinflammatory cytokines is one of the causes of inefficient hemopoiesis under chronic disorders anemia.
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Zhang L, Li X, Gu Q, Zhu Y, Zhao H, Li Y, Zhang Z. Effects of subchronic aluminum exposure on serum concentrations of iron and iron-associated proteins in rats. Biol Trace Elem Res 2011; 141:246-53. [PMID: 20563666 DOI: 10.1007/s12011-010-8725-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 05/03/2010] [Indexed: 10/19/2022]
Abstract
The purpose of the study was to investigate the effect of subchronic aluminum (Al) exposure on iron (Fe) homeostasis in rats. One hundred Wistar rats were divided into two groups. Experimental rats were given drinking water containing aluminum chloride (AlCl(3), 430 mg Al(3+)·L(-1)), while control rats were given distilled water for up to 150 days. Ten rats were sacrificed in each group every 30 days. Mean corpuscular hemoglobin (MCH), and serum levels of Al, Fe, transferrin (TF), total iron binding capacity (TIBC), and soluble transferrin receptor (sTfR) were measured. Al-treated rats showed significantly decreased bodyweight and increased Al and Al/Fe levels during the experimental period. Fe levels and MCH were higher on day 150 in the experimental group than in the control group. TF content and TIBC were higher, whereas erythrocyte counts and sTfR content were lower in the experimental group than in the control group from days 90 and 60, respectively. Longer duration of Al administration increased the serum levels of Al, TF, Al/Fe, and TIBC and decreased sTfR. MCH and Fe levels decreased first, and then increased. The results indicate that chronic exposure to Al disturbed Fe homeostasis.
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Affiliation(s)
- Lichao Zhang
- College of veterinary medicine, Northeast Agricultural University, Harbin, 150030, People's Republic of China
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Saccà F, Piro R, De Michele G, Acquaviva F, Antenora A, Carlomagno G, Cocozza S, Denaro A, Guacci A, Marsili A, Perrotta G, Puorro G, Cittadini A, Filla A. Epoetin alfa increases frataxin production in Friedreich's ataxia without affecting hematocrit. Mov Disord 2011; 26:739-42. [PMID: 21506154 DOI: 10.1002/mds.23435] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 07/02/2010] [Accepted: 08/12/2010] [Indexed: 08/30/2023] Open
Abstract
Objective of the study was to test the efficacy, safety, and tolerability of two single doses of Epoetin alfa in patients with Friedreich's ataxia. Ten patients were treated subcutaneously with 600 IU/kg for the first dose, and 3 months later with 1200 IU/kg. Epoetin alfa had no acute effect on frataxin, whereas a delayed and sustained increase in frataxin was evident at 3 months after the first dose (+35%; P < 0.05), and up to 6 months after the second dose (+54%; P < 0.001). The treatment was well tolerated and did not affect hematocrit, cardiac function, and neurological scale. Single high dose of Epoetin alfa can produce a considerably larger and sustained effect when compared with low doses and repeated administration schemes previously adopted. In addition, no hemoglobin increase was observed, and none of our patients required phlebotomy, indicating lack of erythropoietic effect of single high dose of erythropoietin.
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Affiliation(s)
- Francesco Saccà
- Department of Neurological Sciences, University Federico II, Napoli, NA, Italy.
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Ho LC, Wang HH, Peng YS, Chiang CK, Huang JW, Hung KY, Hu FC, Wu KD. Clinical utility of malnutrition-inflammation score in maintenance hemodialysis patients: focus on identifying the best cut-off point. Am J Nephrol 2008; 28:840-6. [PMID: 18535370 DOI: 10.1159/000137684] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 04/15/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Malnutrition-inflammation score (MIS) is a comprehensive and quantitative system to assess malnutrition-inflammation complex syndrome, and a strong correlation between MIS and morbidity/mortality in maintenance hemodialysis (MHD) patients had been demonstrated. However, there is no cut-off value of MIS to categorize patients into high risk or low risk patients. METHODS A total of 257 chronic stable and ambulatory adult MHD patients from Far Eastern Memorial Hospital were enrolled for the study. The MIS of each patient was recorded at the initiation of study and the study population was followed up as a 12-month prospective cohort to evaluate mortality as the primary outcome. RESULTS Twelve patients died in the 12-month observational period. Both multiple logistic regression analyses and Cox proportional hazards model denoted MIS, alkaline phosphatase, transferrin saturation, ferritin, and total iron binding capacity as significant predictors of 1-year mortality. The conditional effect plot of MIS on 1-year mortality revealed that when fixing the alkaline phosphatase, transferrin saturation, ferritin, and total iron binding capacity at a mean value, the probability of death for an MHD patient whose MIS was 3, 4, and 5 is 10, 40, and 80%, respectively. CONCLUSIONS Our study shows that MHD patients with MIS score of more than 4-5 had a significant risk of 1-year mortality. Additional risk factors associated with short-term mortality besides malnutrition-inflammation complex syndrome were anemia and renal osteodystrophy. This study proves that MIS is a useful tool to risk-stratify Asian MHD patients and to identify those at risk of short-term death. Nutritional interventions that can improve the MIS may also improve survival, but this hypothesis needs to be verified in interventional studies.
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Affiliation(s)
- Li-chun Ho
- Department of Internal Medicine, National Taiwan University Hospital, School of Medicine, National Taiwan University, Taipei, Taiwan, ROC
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Boesch S, Sturm B, Hering S, Goldenberg H, Poewe W, Scheiber-Mojdehkar B. Friedreich's ataxia: clinical pilot trial with recombinant human erythropoietin. Ann Neurol 2007; 62:521-4. [PMID: 17702040 DOI: 10.1002/ana.21177] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To determine the role of recombinant human erythropoietin as a possible treatment option in Friedreich's ataxia, we performed an open-label clinical pilot study. Primary outcome measure was the change of frataxin levels at week 8 versus baseline. Twelve Friedreich's ataxia patients received 5,000 units recombinant human erythropoietin three times weekly subcutaneously. Frataxin levels were measured in isolated lymphocytes by enzyme-linked immunosorbent assay. In addition, urinary 8-hydroxydeoxyguanosine and serum peroxides, were measured. Treatment with recombinant human erythropoietin showed a persistent and significant increase in frataxin levels after 8 weeks (p < 0.01). All patients showed a reduction of oxidative stress markers.
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Affiliation(s)
- Sylvia Boesch
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Ekblom K, Hultdin J, Stegmayr B, Johansson I, Van Guelpen B, Hallmans G, Weinehall L, Johansson L, Wiklund PG, Marklund SL. Iron Stores and HFE Genotypes Are Not Related to Increased Risk of Ischemic Stroke. Cerebrovasc Dis 2007; 24:405-11. [PMID: 17878720 DOI: 10.1159/000108429] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Accepted: 04/24/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High iron levels can increase the formation of noxious oxygen radicals, which are thought to contribute to cerebrovascular disease. The aim of this prospective study was to determine if iron status and HFE genotypes constitute risk factors for stroke. METHODS First-ever stroke cases (231 ischemic and 42 hemorrhagic) and matched double referents from the population-based Northern Sweden cohorts were studied in a nested case-referent setting. RESULTS For total iron binding capacity, an increased risk of ischemic stroke was seen in the highest quartile (OR 1.80; 95% CI 1.14-2.83; p for trend 0.012). The highest quartile of transferrin iron saturation showed a decreased risk of ischemic stroke in men (OR 0.44; 95% CI 0.22-0.87; p for trend 0.028), but not in women. There was an increased risk of hemorrhagic stroke in the second (OR 4.07; 95% CI 1.09-15.20) and third quartile (OR 4.22; 95% CI 1.08-16.42) of ferritin. Neither quartiles of plasma iron concentrations nor the HFE C282Y and H63D genotypes were associated with ischemic or hemorrhagic stroke. CONCLUSIONS Iron stores were not positively related to increased risk of ischemic stroke. Furthermore, HFE genotypes did not influence the risk of ischemic or hemorrhagic stroke.
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Affiliation(s)
- Kim Ekblom
- Clinical Chemistry, Department of Medical Biosciences, Umeå University, Umeå, Sweden.
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Nahounou Bléyéré M, Joulia Ekaza D, Yapo Angoué P, Datté Yao J, N'guessan Banga B, Neil Cathy AM, Vanga M, Koné M, Ehilé Ehouan E. [Heterogeneity of the iron status in the woman population during the pregnancy in Côte-d'Ivoire]. Ann Biol Clin (Paris) 2007; 65:525-32. [PMID: 17913671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Accepted: 07/03/2007] [Indexed: 05/17/2023]
Abstract
The iron deficiency is a major problem of public health in the African countries, particularly in pregnant women population. The aim of our study was to appreciate the iron status during the pregnancy period (first, second and three trimesters); to realize an evaluation and to characterize the biological indicators of pregnant women. Our study was carried out in four medical and urban units of Abidjan in Côte-d'Ivoire with 531 pregnant women. The biological parameters significantly reduced in the third trimester of the pregnancy. But, an enhancement of the transferrin and the total iron binding capacity was observed. Moreover, 66 % of pregnant women presented iron deficiency anaemia (p < 0.01). In conclusion, the study shows that no pregnant woman presented iron normal status in the third trimester of the pregnancy.
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Affiliation(s)
- M Nahounou Bléyéré
- Laboratoire de physiologie animale, pharmacologie et phytothérapie, Université d'Abobo-Adjamé, Côte-d'Ivoire.
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43
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Abstract
Standing orders serve an important role in various healthcare settings by empowering nurses to implement certain procedures and activities on behalf of physicians, enabling more immediate interventions, and ultimately improving patient care. Standing orders are based on established clinical practice guidelines and are well suited for supportive interventions. Several evidence-based clinical practice guidelines are available for the treatment of anemia in patients with cancer. The guidelines can serve as a basis for the development of standing orders for the management of treatment-related anemia in patients with cancer, which will enable the delivery of consistently high-quality care to patients. A major advantage to the implementation of standing orders is that patients with suboptimal hemoglobin levels can be treated by oncology nurses in a timely manner and receive high-quality care that is consistent with available clinical evidence.
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Affiliation(s)
- Jon Mickle
- James Cancer Hospital and Solove Research Institute, Columbus, OH, USA.
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44
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Rangarajan S, D'Souza GA. Restless legs syndrome in Indian patients having iron deficiency anemia in a tertiary care hospital. Sleep Med 2007; 8:247-51. [PMID: 17368978 DOI: 10.1016/j.sleep.2006.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Revised: 10/02/2006] [Accepted: 10/02/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Prevalence of restless legs syndrome (RLS) in India is unknown. Up to 25% of Caucasian RLS patients also have iron deficiency. The main objective of the study was to find occurrence of RLS in patients with iron deficiency anemia and compare it to non-anemic healthy people. PATIENTS AND METHODS This was a cross-sectional study from April 2003 to October 2004 done in in-patient and out-patient services of Medicine department, St. John's Medical College Hospital, Bangalore, India. Sixty-four consecutive adult patients with iron deficiency and 256 age- and sex-matched non-anemic participants were interviewed face-to-face. Hemogram was done in all participants, and free erythrocyte protoporphyrin (FEP) and total iron binding capacity (TIBC) in anemic patients. RESULTS RLS symptoms were present in 6.25% of healthy participants and 34.37% of anemic patients (p<0.001). Chronic menorrhagia (p=0.001) and repeated blood donation (5 times) (p=0.009) were associated with increased RLS occurrence. RLS was associated with delayed onset of sleep (p<0.001). CONCLUSION RLS, a common occurrence among healthy participants, occurred at a significantly higher rate among iron-deficient anemic patients. Further studies are warranted to better characterize RLS in India.
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Affiliation(s)
- Sunad Rangarajan
- Division of Chest Diseases, Department of Medicine, St. John's Medical College Hospital, Bangalore, India.
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45
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Abstract
The occurrence of restless legs syndrome in pregnancy is well known. However, the mechanism of this association is unclear. In this study, we aimed to identify the factors that predispose women to have restless legs syndrome during pregnancy. A total of 146 pregnant women were included in the study. Patients were asked questions regarding demographic characteristics, complications of pregnancy, medical therapy (vitamin and iron intake), sleep disorders, muscle cramps, and excessive daytime sleepiness. Electroneurography, routine blood biochemistry tests, complete blood count, and thyroid function tests were performed and vitamin B12, folic acid, serum iron, iron-binding capacity, ferritin, iron saturation, prolactin, estradiol, and progesterone were measured. Of the participants, 38 were diagnosed as having restless legs syndrome. In women with restless legs syndrome, additional medical problems, night cramps, and excessive daytime sleepiness were more frequent. In women without restless legs syndrome, serum hemoglobin levels were significantly higher and the use of supplemental iron or vitamins was greater. Among the women with restless legs syndrome, progesterone levels were slightly higher but this difference was not statistically significant. In summary, in this study, lower hemoglobin levels and supplementation deficits of iron and vitamins were found be the risk factors for restless legs syndrome in pregnancy.
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Affiliation(s)
- Tuğba Tunç
- Department of Neurology, Ankara Research and Training Hospital, Ministry of Health, Ankara, Turkey.
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46
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Easom A. The challenges of using serum ferritin to guide i.v. iron treatment practices in patients on hemodialysis with anemia. Nephrol Nurs J 2006; 33:543-51; quiz 552-3. [PMID: 17044438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Expert guidelines recommend routine administration of intravenous iron therapy and frequent monitoring of iron status for patients on hemodialysis who are being treated for anemia with erythropoiesis-stimulating agents. However, monitoring iron status using conventional markers, such as serum ferritin, may be complicated by acute and chronic inflammation and malnutrition, which are common in this patient population. Therefore, nephrology nurses must be knowledgeable of the limitations of using serum ferritin to assess iron status and how to interpret high serum ferritin values to effectively treat patients on hemodialysis with anemia.
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Affiliation(s)
- Andrea Easom
- University of Arkansas for Medical Sciences, College of Medicine, Nephrology Division, Little Rock, USA
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Zimmermann MB, Biebinger R, Rohner F, Dib A, Zeder C, Hurrell RF, Chaouki N. Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron. Am J Clin Nutr 2006; 84:580-6. [PMID: 16960172 DOI: 10.1093/ajcn/84.3.580] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vitamin A deficiency impairs iron metabolism; vitamin A supplementation of vitamin A-deficient populations may reduce anemia. The mechanism of these effects is unclear. In vitro and in animal models, vitamin A treatment increases the production of erythropoietin (EPO), a stimulant of erythropoiesis. OBJECTIVE We measured the effect of vitamin A supplementation on hemoglobin, iron status, and circulating EPO concentrations in children with poor iron and vitamin A status. DESIGN In a double-blind, randomized trial, Moroccan schoolchildren (n = 81) were given either vitamin A (200,000 IU) or placebo at baseline and at 5 mo. At baseline, 5 mo, and 10 mo, hemoglobin, indicators of iron and vitamin A status, and EPO were measured. RESULTS At baseline, 54% of children were anemic; 77% had low vitamin A status. In the vitamin A group at 10 mo, serum retinol improved significantly compared with the control group (P < 0.02). Vitamin A treatment increased mean hemoglobin by 7 g/L (P < 0.02) and reduced the prevalence of anemia from 54% to 38% (P < 0.01). Vitamin A treatment increased mean corpuscular volume (P < 0.001) and decreased serum transferrin receptor (P < 0.001), indicating improved iron-deficient erythropoiesis. Vitamin A decreased serum ferritin (P < 0.02), suggesting mobilization of hepatic iron stores. Calculated from the ratio of transferrin receptor to serum ferritin, overall body iron stores remained unchanged. In the vitamin A group at 10 mo, we observed an increase in EPO (P < 0.05) and a decrease in the slope of the regression line of log10(EPO) on hemoglobin (P < 0.01). CONCLUSION In children deficient in vitamin A and iron, vitamin A supplementation mobilizes iron from existing stores to support increased erythropoiesis, an effect likely mediated by increases in circulating EPO.
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Affiliation(s)
- Michael B Zimmermann
- Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zürich, Switzerland, and The Ministry of Health, Rabat, Morocco.
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48
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Abstract
We assessed haematological parameters and possible modifications in elite rugby players throughout a competitive season for increasing the knowledge of physiological characteristics of these sportsmen. Blood samples were collected from the members of the Italian National rugby team at four consecutive training camps during a whole competitive season. Forty-four athletes were recruited for the first camp, 36 for the second, 30 for the third and 32 for the fourth. Due to turnover of the subjects during the season only 13 athletes could be examined at all four camps, and another six in the first three camps. Therefore, we selected the data of these 19 athletes. Iron and transferrin saturation were stable, whilst ferritin increased at the end of the season. The modifications of the soluble transferrin receptor (sTFR) were linked to those of haematocrit: sTFR increased after training and during the competition period when haemoglobin and haematocrit decreased, and decreased at the end of the season. Haemoglobin and haematocrit showed slightly higher levels during the first part of the season and decreased in the second half, when physical demand was high, as demonstrated by biochemical additional tests. Leucocytes and platelets were stable throughout the season. Haematological and iron metabolism parameters in the elite rugby players examined during a whole season fall within physiological range of values. The variability of the parameters during the season is related to training and competition workload. Reticulocytes and sTFR are the most sensitive parameters for studying the iron metabolism of the athletes.
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Affiliation(s)
- G Banfi
- Istituto Ortopedico Galeazzi, Milan, Italy.
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49
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Abstract
OBJECTIVE To evaluate the levels of thiobarbituric acid reactive substances (TBARS), uric acid, and seric superoxide dismutase and catalase activities, as well as total serum iron, total iron-binding capacity (TIBC), erythrocyte osmotic fragility, and hemograms in people with Down syndrome. PARTICIPANTS AND METHODS The study sampled (July to December 2003) 50 people with Down syndrome and 50 individuals without Down syndrome (control group) matched by age and sex. The levels of TBARS were measured by the TBARS method. Serum superoxide dismutase and catalase activities and uric acid levels were determined spectrophotometrically. Erythrocyte osmotic fragility was assessed by the percentage of hemolysis. Hemograms, total serum iron level, and TIBC were determined with automated systems. RESULTS The results showed that levels of TBARS, uric acid, and seric superoxide dismutase and catalase activities were higher in the Down syndrome group compared with the control group. We also observed a slight increase in erythrocyte osmotic fragility in the Down syndrome group, but the total serum iron levels, TIBC, and hemograms for both groups were within the age-related reference values. CONCLUSION This was the first time, to our knowledge, that increases in seric superoxide dismutase and catalase activities were observed in people with Down syndrome. Although other studies are necessary, our results add to the understanding of the mechanisms responsible for the increased oxidative stress observed in individuals with Down syndrome and may be useful in supporting future antioxidant therapies that will improve the lives of people with Down syndrome.
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Affiliation(s)
- Márcia E Garcez
- Instituto de Biotecnologia e Departamento de Ciências Biomédicas, Universidade de Caxias do Sul, RS, Brazil
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50
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Iolascon A, d'Apolito M, Servedio V, Cimmino F, Piga A, Camaschella C. Microcytic anemia and hepatic iron overload in a child with compound heterozygous mutations in DMT1 (SCL11A2). Blood 2005; 107:349-54. [PMID: 16160008 DOI: 10.1182/blood-2005-06-2477] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Divalent metal transporter 1 (DMT1) mediates apical iron uptake in duodenal enterocytes and iron transfer from the transferrin receptor endosomal cycle into the cytosol in erythroid cells. Both mk mice and Belgrade rats, which carry an identical DMT1 mutation, exhibit severe microcytic anemia at birth and defective intestinal iron use and erythroid iron use. We report the hematologic phenotype of a child, compound heterozygote for 2 DMT1 mutations, who was affected by severe anemia since birth and showed hepatic iron overload. The novel mutations were a 3-bp deletion in intron 4 (c.310-3_5del CTT) resulting in a splicing abnormality and a C>T transition at nucleotide 1246(p. R416C). A striking reduction of DMT1 protein in peripheral blood mononuclear cells was demonstrated by Western blot analysis. The proband required blood transfusions until erythropoietin treatment allowed transfusion independence when hemoglobin levels between 75 and 95 g/L (7.5 and 9.5 g/dL) were achieved. Hematologic data of this patient at birth and in the first years of life strengthen the essential role of DMT1 in erythropoiesis. The early onset of iron overload indicates that, as in animal models, DMT1 is dispensable for liver iron uptake, whereas its deficiency in the gut is likely bypassed by the up-regulation of other pathways of iron use.
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Affiliation(s)
- Achille Iolascon
- Genetica Medica, Dipartimento di Biochimica e Biotecnologie Mediche, Università Federico II, Naples, Italy.
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