1,721,040 research outputs found
Deironing the spleen with luspatercept
No full textIn this issue of Blood, Denton et al1 show that luspatercept induces iron redistribution by reducing splenic iron without changing liver iron content in patients with 0-thalassemia (0-thal). This challenges the understanding that the iron content of the liver reflects total body iron and suggests that magnetic resonance imaging (MRI) scans should ideally include the liver and spleen to adequately monitor iron status in patients with iron-loading anemias treated with an erythroid maturation agent
Iron replacement therapy: entering the new era without misconceptions, but more research is needed
No full textIron replacement therapy dates back to the 17th century, when Sydenham first proposed the use of an oral iron salt to treat "chlorosis", a disorder of adolescent girls and young women initially believed to be an hysterical disease, but later recognised as due to iron deficiency anaemia. The first iron preparations for intravenous (IV) administration entered the clinical scenario in the second half of the past century. They were based on a common structure, i.e. a carbohydrate shell surrounding a core containing Fe3+ hydroxide particles. The newer preparations also share this structure, the difference lying in the chemistry of the carbohydrate moieties forming the shell. High molecular weight iron dextran was used initially, but soon raised safety concerns due to an unacceptable rate of severe adverse effects, including death due to anaphylaxis. This fostered fears that strongly limited physicians' use of parenteral iron and created emotional barriers which still partially remain
The Role of Iron Staining in Myelodysplastic Syndromes: A Treasure Trove of Information
No full textNot availabl
Diagnosis and management of hereditary hemochromatosis: lifestyle modification, phlebotomy, and blood donation
No full textThe term hemochromatosis refers to a group of genetic disorders characterized by hepcidin insufficiency in the context of normal erythropoiesis, iron hyperabsorption, and expansion of the plasma iron pool with increased transferrin satura tion, the diagnostic hallmark of the disease. This results in the formation of toxic non-transferrinbound iron, which ulti mately accumulates in multiple organs, including the liver, heart, endocrine glands, and joints. The most common form is HFE hemochromatosis (HFEH) due to p.Cys282Tyr (C282Y) homozygosity, present in nearly 1 in 200 people of Northern European descent but characterized by low penetrance, particularly in females. Genetic and lifestyle cofactors (espe cially alcohol and dysmetabolic features) significantly modulate clinical expression so that HFE H can be considered a multifactorial disease. Nowadays, HFE H is mostly diagnosed before organ damage and is easily treated by phlebotomy, with an excellent prognosis. After iron depletion, maintenance phlebotomy can be usefully transformed into a blood donation program. Lifestyle changes are important for management. NonHFEH, much rarer but highly penetrant, may lead to early and severe heart, liver, and endocrine complications. Managing severe hemochromatosis requires a compre hensive approach optimally provided by consultation with specialized centers. In clinical practice, a proper diagnostic approach is paramount for patients referred for hyperferritinemia, a frequent finding that reflects hemochromatosis only in a minority of cases
Sparing unnecessary transfusions through patient blood management: time for application also in internal and emergency medicine
No full textNo abstract availabl
Il Crocifisso di Donatello e la cappella del Beato Gherardo da Villamagna in Santa Croce: indagini per una ricostruzione
No full textIron metabolism in infections: Focus on COVID-19
Full text linkIron is a micronutrient essential for a wide range of metabolic processes in virtually all living organisms. During infections, a battle for iron takes place between the human host and the invading pathogens. The liver peptide hepcidin, which is phylogenetically and structurally linked to defensins (antimicrobial peptides of the innate immunity), plays a pivotal role by subtracting iron to pathogens through its sequestration into host cells, mainly macrophages. While this phenomenon is well studied in certain bacterial infections, much less is known regarding viral infections. Iron metabolism also has implications on the functionality of cells of the immune system. Once primed by the contact with antigen presenting cells, lymphocytes need iron to sustain the metabolic burst required for mounting an effective cellular and humoral response. The COVID-19 pandemic has boosted an amount of clinical and translational research over the possible influences of nutrients on SARS-CoV-2 infection, in terms of either susceptibility or clinical course. Here we review the intersections between iron metabolism and COVID-19, belonging to the wider domain of the so-called "nutritional immunity". A better understanding of such connections has potential broad implications, either from a mechanistic standpoint, or for the development of more effective strategies for managing COVID-19 and possible future pandemics. (c) 2021 Elsevier Inc. All rights reserved
Inflammation and iron homeostasis - what do blood tests mean?
No full textMultiple links between inflammation and iron homeostasis exist, the most important being centered on hepcidin, the master regulator of iron homeostasis, a defensin-like peptide that acts by binding and inactivating the cell iron exporter ferroportin. The pro-inflammatory cytokine IL-6 is one of the most powerful stimuli to hepcidin synthesis, which causes macrophage iron retention and a reduction of enterocyte iron absorption. This results in a reduction of extracellular iron, which is essential for many pathogens but also for immune cells. Inflammation perturbates the levels of classical laboratory markers of iron status, like ferritin, serum iron, and transferrin (and hence transferrin saturation [TSAT). Thus, they are often difficult to interpret during infections or other acute and chronic sterile inflammatory states. Other laboratory parameters, like hepcidin, soluble transferrin receptor (sTfR), percentage of hypochromic erythrocytes (%HYPO), and reticulocyte hemoglobin content (CHr), have been proposed to better assess iron status during inflammation. An accurate evaluation of iron status in the anemia of inflammation and anemia of chronic disorders (ACD) is key to establishing a possible indication to iron supplementation and represents an area of active researc
Practical implications of the 2019 Nobel Prize in Physiology or Medicine: from molecular adaptation to hypoxia to novel anti-anemic drugs in the clinic
Full text linkThe 2019 Nobel Prize for Medicine or Physiology was assigned to three prestigious physician-scientists, Gregg L. Semenza, William G. Kaelin, and Peter J. Ratcliffe, who clarified the molecular mechanisms of hypoxia adaptation. This viewpoint traces their fundamental findings, which have paved the way for the development of innovative drugs for a wide range of common diseases, including cancer and anemia
Anemia and iron deficiency in heart failure: extending evidences from chronic to acute setting
No full textAnemia and iron deficiency in heart failure: extending evidences from chronic to acute settin
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