Necesidades de investigación para el diagnóstico de anemia en poblaciones de altura / Diagnosis of anemia in populations at high altitudes

Tanto la deficiencia como la sobrecarga de hierro son situaciones que ponen en riesgo la salud y la vida de las personas, por lo que es importante mantener su homeostasis. Como la hemoglobina contiene 70% del hierro del organismo, la OMS recomienda su medición para determinar la prevalencia de anemia por deficiencia de hierro (ID), a pesar que ellos mismos reconocen que la anemia no es específica de ID. Como la hemoglobina aumenta con la altitud de residencia, la OMS recomienda corregir el punto de corte para definir anemia en la altura. Una objeción a esta corrección es que el aumento de la hemoglobina en la altura no es universal ni aumenta de manera lineal. Además, las poblaciones de mayor antigüedad generacional tienen menos hemoglobina que las más recientes. En infantes, niños, gestantes y adultos, la prevalencia de anemia usando hemoglobina corregida es 3-5 veces mayor que usando marcadores del estatus de hierro. Los programas estatales buscan combatir la anemia mediante la suplementación de hierro; no obstante, resultan ineficaces, especialmente en las poblaciones de altura. Entonces, ¿hay deficiencia de hierro en la altura? Los niveles de hepcidina sérica, hormona que regula la disponibilidad de hierro, son similares a los de nivel del mar indicando que en la altura no hay deficiencia de hierro. Un problema adicional al corregir la hemoglobina por la altura, es que las prevalencias de eritrocitosis disminuyen. En conclusión, la corrección del punto de corte de la hemoglobina en la altura para determinar deficiencia de hierro es inadecuada.

Iron deficiency and overload are risk factors for numerous poor health outcomes, and thus the maintenance of iron homeostasis is vital. Considering that hemoglobin contains 70% of the total iron in the body, the World Health Organization (WHO) recommends the measurement of iron levels to calculate the rate of iron deficiency anemia (IDA), although WHO recognizes that IDA is not the only cause of anemia. As hemoglobin increases with altitude, WHO recommends correcting the cut-off point to define anemia at high altitudes. An objection to this correction is that the increase in hemoglobin at high altitudes is not universal and is not linear. In addition, individuals in older age groups have lower hemoglobin levels than those in younger age groups. In infants, children, pregnant women, and adults, the prevalence of anemia using corrected hemoglobin is 3-5 times higher than that using markers of iron status. State programs seek to control anemia by means of iron supplementation. However, these programs are ineffective, particularly for high-altitude populations. Therefore, the occurrence of iron deficiency at high altitudes is controversial. The serum levels of the hormone hepcidin, which regulates iron availability, are similar in individuals at high altitudes to those of individuals at sea level, indicating that iron deficiency does not occur at high altitudes. An additional problem when correcting hemoglobin at high altitudes is that the frequency of erythrocytosis is decreased. In conclusion, the correction of the cut-off point of hemoglobin at high altitudes to determine iron deficiency is inadequate.

Influência da hipomagnesemia sobre a homeostase do ferro e estresse oxidativo no diabetes mellitus tipo 2 / Influence of hypomagnesemia on iron homeostasis and oxidative stress in type 2 diabetes mellitus

OBJECTIVE: This review aims to bring updated information about the influence of magnesium deficiency on iron homeostasis and oxidative stress in type 2 diabetics. Data source: A bibliographic search was conducted in the databases Bireme, SciELO, Science Direct, PubMed and Portal.periodicos.Capes using the following descriptors: "diabetes mellitus", "magnesium", "iron", "oxidative stress" and "malondialdehyde". Fifty articles related to this literature were selected. Data synthesis: Several studies have shown the influence of hypomagnesemia on oxidative stress in type 2 diabetics. Deficiency of this mineral seems to be related to the induction of hemolysis, which favors the release of iron with overload of this mineral in the body, allowing an increase of the hydroxyl radical through the Fenton reaction and, consequently, oxidative stress. The increase in free iron contributes significantly to the manifestation of lipid peroxidation, which triggers a sequence of lesions in the cell with loss of selectivity in ion exchange and release of the contents of organelles, such as the hydrolytic enzymes of lysosomes, and the formation of cytotoxic products, such as malondialdehyde. CONCLUSIONS: There is scientific evidence that magnesium deficiency alters iron compartmentalization in the body; however, new studies are needed to bring information that would enable the biochemical understanding of the importance of the balance of magnesium and iron concentrations in protecting against the oxidative stress present in type 2 diabetes

OBJETIVO: Esta revisão visa trazer informações atualizadas sobre a influência da deficiência de magnésio na homeostase do ferro e estresse oxidativo em diabéticos tipo 2. Fonte de dados: O levantamento bibliográfico foi realizado nas bases de dados Bireme, Scielo, Science Direct, periódicos Capes e Pubmed com os seguintes descritores: "diabetes mellitus", "magnésio", "ferro", "estresse oxidativo" e "malondialdeído". Foram selecionados 50 artigos entre os relacionados por essa pesquisa bibliográfica. Síntese dos dados: Diversos estudos têm mostrado a influência da hipomagnesemia sobre o estresse oxidativo em diabéticos tipo 2, sendo que a deficiência desse mineral parece estar relacionada à indução da hemólise dos eritrócitos, que favorece a liberação do ferro com sobrecarga desse mineral no organismo, o que possibilita aumento do radical hidroxila por meio da reação de Fenton e, consequentemente, o estresse oxidativo. O aumento de ferro livre contribui de forma relevante para a manifestação da peroxidação lipídica, que desencadeia sequência de lesões na célula, com perda da seletividade na troca iônica e liberação do conteúdo de organelas, como as enzimas hidrolíticas dos lisossomas e a formação de produtos citotóxicos, como o malondialdeído. CONCLUSÕES: Há evidências científicas de que a deficiência de magnésio altera a compartimentalização do ferro no organismo, entretanto a realização de novos estudos é necessária para trazer informações que permitam o entendimento bioquímico da importância do equilíbrio das concentrações de magnésio e ferro na proteção contra o estresse oxidativo presente no diabetes tipo 2

Hepcidina: su interacción con la hemojuvelina y su aporte en el diagnóstico de las enfermedades relacionadas con el metabolismo del hierro / Hepcidin: Interaction with Hemojuvelin and its Contribution in the Diagnosis of Diseases Related to Iron Metabolism

La hepcidina es una hormona peptídica, producida en el hígado y considerada unregulador del metabolismo del hierro. Su regulación está dirigida a la absorciónintestinal del hierro y a la función de la ferroportina dentro de la célula, a fin demantener un balance entre el consumo y las reservas de hierro. Esta hormona, a suvez, está regulada por procesos inflamatorios, estados de anemia ferropénica, actividadhematopoyética y algunas vías de señalización como SMAD, STAT y JAK. En estasvías interviene una proteína de membrana llamada hemojuvelina, la cual actúa comoun correceptor de la proteína morfogenética ósea, cuya función es inducir el gende transcripción de la hepcidina mediante la vía SMAD1/5/8-SMAD4. Debido a laasociación de la hemojuvelina con la expresión de la hepcidina y la relación de estaúltima con procesos inflamatorios y regulación del metabolismo del hierro, se hanpropuesto algunas técnicas para la determinación de ambas proteínas como Elisa,Dotblot, inmunoensayos y SELDI-TOF MS...

The hepcidin is a peptide hormone produced by theliver with anti-bacterial activity, is involved in regulationiron metabolism, making it possible to useit as another parameter to assess some entities relatedto disorders associated with iron metabolism.Hepcidin regulates intestinal absorption of ironlevel and the role of ferroportin in the cell, preventingeither iron overload or iron consumptionreserve, this is turn regulating for inflammatorystimuli, iron store, erythropoietic activity andsignaling patway SMAD,STAT and JAK; in thissignaling patway involved a membrane proteincalled hemojuvelin. The hemojuvelin acts as abone morphogenetic protein co-receptor, theyinduce hepcidin gene transcription through theSMAD1/5/8-SMAD4. Because of the associationsof hemojuveline with hepcidin expression andthe relationship of the latter with inflammatoryprocesses and regulations of iron metabolismhave been proposed some techniques for the determinationof both proteins as Elisa, Dotblot,Immunoassays and SELDI-TOF MS...

Micronutrientes no crescimento e desenvolvimento infantil / Micronutrients in child growth and development

OBJETIVO: abordar a importância dos micronutrientes zinco, ferro e vitamina A no crescimento linear e desenvolvimento infantil. MÉTODO: foram consultadas as bases de dados Medline e LILACS utilizando duas estratégias de busca: i) growth AND zinc AND iron AND vitamin A AND child, preschool OR infant, para o tema micronutrientes e crescimento; e ii) child development AND zinc AND iron AND vitamin A, para o tema micronutrientes e desenvolvimento. Os artigos foram classificados quanto ao tipo de manuscrito e principais resultados. RESULTADOS: foram incluídos 19 artigos referentes ao crescimento e 5 artigos referentes ao desenvolvimento. DISCUSSÃO: considerando as prevalências, sugere-se que as deficiências de ferro e zinco devem contribuir, concurrentemente, com o déficit de estatura. O papel do zinco no sistema hormonal primário justifica ser o nutriente de maior importância no crescimento, afetando a estatura das crianças tanto em estados de deficiência leve como moderada. Evidências fisiológicas e experimentais colocam a importância dos micronutrientes ferro e zinco no desenvolvimento e déficit cognitivo nos primeiros anos da vida. Apesar disso, os resultados ainda não são conclusivos. Pensa-se que o zinco pode limitar processos neuropsicológicos específicos, já o ferro é essencial para o funcionamento do sistema neuro-transmissor. Estudar o efeito das deficiências de micronutrientes no desenvolvimento apresenta vários problemas metodológicos e analíticos. O crescimento e desenvolvimento representam um processo com determinação comum no qual a deficiência de zinco pode representar a forma mais comum em que o crescimento linear poderia ser utilizado como um bom preditor de desenvolvimento cognitivo

Fisiologia e metabolismo do ferro: [revisão] / Iron physiology and metabolism: [review]

O conhecimento sobre a fisiologia e metabolismo do ferro foi bastante incrementado nos últimos anos. A identificação de alguns genes e as repercussões quando de suas mutações, principalmente as relacionadas ao acúmulo de ferro, auxiliaram no entendimento dos mecanismos regulatórios responsáveis pela manutenção da homeostase desse nutriente essencial para numerosos processos bioquímicos. A função de diversas moléculas já está bem estabelecida, como da transferrina e seu receptor e, nas últimas décadas, novas moléculas têm sido identificadas, como a ferroportina, o transportador de metal divalente e hemojuvelina. Um elegante mecanismo de controle mantém o equilíbrio entre os processos de absorção do ferro, reciclagem, mobilização, utilização e estoque. Alterações no sincronismo desses processos podem causar tanto a deficiência como a sobrecarga de ferro, ambos com importantes repercussões clínicas para o paciente. Nessa minirrevisão serão abordados aspectos relacionados ao metabolismo do ferro e à participação de várias proteínas e mediadores envolvidos. Serão também apresentados os mecanismos regulatórios celular e sistêmico responsáveis pela disponibilidade do ferro em concentrações ideais para a manutenção de sua homeostase.

Knowledge of the iron physiology and metabolism has increased greatly over the last few years. The identification of genes and the consequences of mutations, especially those related to the accumulation of iron, have improved the understanding of the regulatory mechanisms responsible for maintaining homeostasis of this essential nutrient in many biochemical processes. The function of several molecules is well established, as in the case of transferrin and its receptor and, in recent decades, new molecules have been identified such as ferroportin, divalent metal transporter, hemojuvelin and hepcidin. An elegant control mechanism maintains the balance between the processes of iron absorption, recycling, mobilization, utilization and storage. Disturbances in the synchronism among those processes may lead either to iron deficiency or to iron overload, both of which have important clinical consequences. This mini-review attempts to describe aspects related to iron metabolism and the participation of several proteins and mediators involved in these mechanisms. Moreover, intracellular and systemic regulation mechanisms responsible for providing the most suitable iron concentration for iron homeostasis maintenance will be presented.

Iron regulated outer membrane proteins (IROMPs) as potential targets against carbapenem-resistant Acinetobacter spp. isolated from a Medical Centre in Malaysia.

Background & objectives: Carbapenem-resistant Acinetobacter spp. have gained increasing significance as opportunistic pathogens in hospitalized patients. Carbapenem resistance is often associated with the loss and/or decrease in outer membrane proteins (OMP) and overexpression of multidrug efflux systems. However, carbapenem-hydrolysing β-lactamases of Ambler Class B (metallo-enzymes) and Ambler Class D (oxacillinases) have also been detected in Acinetobacter spp. In this study we have investigated the role of the iron regulated outer membrane protein (IROMPs) and the loss of a 29-kDa OMP in carbapenem resistance of Acinetobacter calcoaceticus. Methods: Carbapenem resistant clinical isolates (n=39) of Acinetobacter baumannii / calcoaceticus were used. Identification of Acinetobacter spp. at species level was done by amplified ribosomal DNA restriction analysis (ARDRA). MIC was evaluated using agar dilution method according to CLSI standards. Presence of outer membrane proteins were determined by SDS-PAGE. A representative strain of A. calcoaceticus, S26 with the loss of 29-kDa OMP was selected for further analysis as strain S26 had unique resistance mechanism, that is, the presence of IMP-4 metallo-β-lactamases. IROMPs were expressed under iron deficit conditions. Bands corresponding to IROMPs were excised from SDS-PAGE and used to immunize rabbits for the production of polyclonal antibodies. The antibodies raised against IROMPs were detected by an in-house ELISA and then used for bactericidal activity against carbapenem resistant A. baumannii / calcoaceticus. Results: All isolates were resistant to all antibiotics including imipenem and meropenem and had loss of a 29-kDa OMP. The polyclonal antibodies showed bactericidal effect against the organism tested and it specifically killed the bacteria grown in iron deficit medium. Interpretation & conclusions: In this study, a 29-kDa OMP has been identified to be the major outer membrane protein in A. baumannii / calcoaceticus and loss of this porin and overexpression of IROMPs have contributed to carbapenem resistance. Polyclonal antibodies raised against IROMPs may have a role in antimicrobial therapy in these isolates.

Suplementación con cobre entre comidas no tiene efecto sobre la nutrición de hierro en hombres / Copper supplementation between meals has no effect on iron status of men

Iron deficiency is prevalent in most of the developing world where it coexists with other micronutrient deficiencies such as copper. Combined supplementation with iron and copper is one of the strategies that can be used to improve the iron and copper status of a population. However, there is concern about potential negative interactions between these two micronutrients due to a competitive binding to the divalent metal transporter 1 (DMTl), a proton-coupled transporter of a variety of divalent metals including copper. The aim of this study was to measure the effect of daily supplementation with 8 mg of copper, as copper sulfate during 6 months on the iron status. Sixty healthy male adults were randomized to receive a copper supplement or a placebo. Fasting blood samples were obtained before and after copper supplementation to evaluate the iron and copper nutritional status. Copper supplementation did not change significantly iron and copper status parameters. In conclusion, daily supplementation with 8 mg of copper during 6 months does not deteriorate iron nutrition in adult men.

La deficiencia de hierro coexiste con otras carencias, entre ellas de cobre. La suplementación combinada con estos nutrientes es una de las estrategias utilizadas en su prevención. Sin embargo, existe la posibilidad de interacciones negativas, ya que el DMT1, principal transportador de hierro no hem a nivel intestinal, también transporta cobre. El propósito del estudio fue medir el efecto de la suplementación con 8 mg diarios de cobre, como sulfato de cobre, durante 6 meses, sobre la nutrición de hierro. Sesenta hombres adultos, aparentemente sanos, fueron seleccionados al azar para recibir el suplemento de cobre o un placebo. Se tomaron muestras de sangre en ayunas antes y después de finalizada la suplementacion para evaluar la nutrición de hierro y de cobre. La suplementacion con cobre no determinó cambios significativos en los indicadores de nutrición de cobre y de hierro. En conclusión, la suplementacion con 8 mg diarios de Cu administrado entre comidas durante 6 meses no deterioró la nutrición de hierro en hombres adultos.

Efecto de la mangiferina y su interacción con hierro sobre la transición de permeabilidad mitocondrial / Effect of mangiferin and its interaction with iron on the transition of mitochondrial permeability

Se considera que junto a las vitaminas y sus precursores, son los principales responsables de los efectos beneficiosos de frutas, vegetales y otros alimentos sobre la salud humana. Sin embargo, el consumo excesivo ya no de sus reservorios naturales sino de los compuestos aislados por medio de suplementos nutricionales y alimento funcionales, ha generado un amplio debate en la comunidad científica, pues numerosos reportes confirman las propiedades pro-oxidantes y citotóxicas de estos compuestos.2 Se ha observado que aquellos que presentan en su estructura una agrupación catecólica, al actuar como antioxidantes, forman derivados quinónicos de oxidación con la capacidad de reaccionar covalentemente con grupos sulfidrilos (SH) (proteicos o no) y afectar la función celular...

Factores predisponentes de anemia en recién nacidos: Hospital Ernesto Segundo Pauline: abril-junio 2005 / Factors related to anemia in newborn: Hospital Ernesto Segundo Pauline: april-june 2005

La anemia es un cuadro clínico y de laboratorio, con incidencia mundial de 34 por ciento primordialmente en países en vías de desarrollo, siendo los niños los más afectados, se manifiesta de muchas formas acarreando problemas irreversibles; como objetivo se planteo determinar la incidencia de anemia en los Recién Nacidos, para lo cual previo consentimiento de las madres se realizó estudio hematológico en las primeras horas del nacimiento a 57 neonatos, evidenciándose que la ausencia de control prenatal, el embarazo en adolescentes y la primiparidad afectan las concentraciones de hemoglobina, lo que nos permite concluir la importancia de programas educativos en salud reproductiva responsable.

Inhibitory effect of deferoxamine on Paracoccidioides brasiliensis survival in human monocytes: reversal by holotransferrin not by apotransferrin

Os mecanismos utilizados pelo Paracoccidioides brasiliensis para sobreviver em células fagocitárias ainda não estão elucidados. O metabolismo celular férrico é muito importante para o crescimento de inúmeros patógenos intracelulares cuja capacidade de se multiplicarem em fagócitos mononucleares é dependente da disponibilidade intracelular do íon ferro. Assim, o objetivo deste trabalho foi investigar o papel do ferro intracelular sobre a capacidade do P. brasiliensis sobreviver em monócitos humanos. O tratamento de monócitos com deferoxamina, uma droga quelante, diminuiu a sobrevivência de leveduras do fungo de forma dose-dependente. O efeito inibidor da deferoxamina sobre a sobrevivência do P. brasiliensis foi revertido por transferrina saturada com ferro (holotransferrina) mas não por transferrina insaturada (apotransferrina). Estes resultados sugerem que a sobrevivência do P. brasiliensis em monócitos humanos é dependente do íon ferro.

impact of sex on iron status in first year of life

Iron deficiency anemia is prevalent allover the world especially in poor countries. Normal iron status is essential for normal behavioral and mental health. Supplementation of iron in the early stages will protect the infant from the permanent psychomotor changes resulting from its deficiency. ZPP/ H ratio is found to be effective in detecting the pre-anemic state. In this study we examined the differences of iron status in female and male infants at the ages of 4, 6 and 12 months. We found that ZPP/H ratio is significantly higher in boys than in girls in the three groups studied denoting their vulnerability to have iron deficiency anemia

Strategies by which some pathogenic trichomonads integrate diverse signals in the decision-marking process

The interaction between each one of Trichomonas vaginalis and Tritrichomonas foetus with their hosts is a complex process in which components associated to the cell surfaces of both parasites and host epithelial cells, and also to soluble components found in vaginal/urethral secretions, are involved. Either cytoadhesion or the cytotoxicity exerted by parasites to host cells can be dictated by virulence factors such as adhesins, cysteine proteinases, laminin-binding proteins, integrins, integrin-like molecules, a cell detachment factor, a pore-forming protein, and glycosidases among others. How trichomonads manipulate informations from the extracellular medium, transduce such informations, and respond to them by stimulating the activities of some surface molecules and/or releasing enzymes are the aspects concerning trichomonal virulence which are here briefly reviewed and discussed.

Niveles séricos de zinc, hierro y cobre en tres grupos de escolares colombianos: relación con algunos parámetros antropométricos

La deficiencia de micronutrientes es frecuente en países en desarrollo. El objetivo del estudio fué comparar los niveles séricos de zinc, hierro y cobre en tres grupos de escolares (8 a 9 años) y correlacionarlos con algunas medidas antropométricas. El grupo 1 estuvo constituido por 26 escolares de un colegio privado de Santafé de Bogotá, el 2 por 21 niños de instituciones públicas de una zona rural, cercana a esta ciudad y el 3 por 28 sujetos de una escuela pública de la capital. Los micronutrientes se midieron por espectrometria de emisión atómica con plasma acoplado por inducción. El grupo 1 presentó talla (126.2+/-3.6) mayor al 2 (122.6+/-4.8 cm) y al 3 (122.1 +/-5.0 cm). Las concentraciones de zinc del grupo 1 (67+/-9 ug/dl) fueron mayores al 2 (59+/-11 ug/dl) y al 3 (50+/-13ug/dl). El grupo 3 presentó sidermia menor (71+/-21ug/dl) al 1 (90+/-30ug/dl). El grupo 1 evidenció niveles de cobre (100+/-19Ug/dl) mayores al 2 (77+/-13ug/dl) y al 3 (82+/-20ug/dl). Los resultados suguieren que los niños de los grupos 2 y 3 están expuestos a posibles condicienes medioambientales que inciden desfavorablemente en su crecimiento corporal y que son los niños del grupo 2 los que presntan el menor acceso a los micronutrientes zinc y hierro.

Anemias nutricionales / Nutritional anemia

La anemia nutricional, especialmente por carencia de hierro, es un problema de vastas proporciones que afecta a cientos de millones de personas en todo el mundo. Aunque los estratos socieconómicos más bajos son los afectados, la carencia de hierro es una de las pocas deficiencias nutricionales que está presente en todas las categorías sociales. Esta carencia puede existir con deficiencia de otros nutrientes, como son: vitamina B12, folatos, proteínas, vitamina C, oligoelementos y otras vitaminas. En el país, los trabajos de Layrisse y col. señalan un incremento entre los años de 1990 y 1994 en la prevalencia de las anemias nutricionales y del déficit de hierro en los grupos más vulnerables. Reportan un aumento en la prevalencia de anemia de 1,6 por ciento y la deficiencia de hierro (niveles bajos de ferritina) de 8,8 por ciento a 15,2 por ciento en niños de 7,11 y 15 años. La anemia representa el último estadio de la deficiencia de hierro, siendo éste el período cuando se presta mayor atención, olvidándose los efectos adversos que ocasiona la deficiencia de hierro en los estadios preliminares sobre las funciones cognitiva, afectiva, desarrollo mental y del lenguaje, capacidad de aprendizaje, coordinación motora, actividad física y disminución de la respuesta inmune

Role of iron and copper during benzene toxicity.

Role of transition metal ions in expression of benzene toxicity has been suggested. Intraperitoneal administration of benzene to female albino rats daily for 10 days resulted in accumulation of iron in liver nuclei, without any change in copper content. Incubation of hydroquinone (HQ), one of the principal metabolites of benzene with rat liver nuclei resulted in formation of thiobarbituric acid reactive products (TBAR). However, presence of bathocuproine, a copper chelator and EDTA, an iron chelator caused significant inhibition of TBAR release. Thus, the present study revealed that iron accumulation and involvement of copper in nuclear damage induced by HQ.

El hierro: amigo y enemigo / The iron: friend and enemy

El hierro es un elemento vital en el organismo de los mamíferos por ser el componente esencial de diversas proteínas y enzimas. Asimismo el hierro actúa como catalizador de las reacciones químicas que producen radicales libres (RL), por lo tanto conviene analizar en qué punto el hierro pasa a ser un elemento necesario a transformarse en un factor de desequilibrio entre los RL y las defensas antioxidantes. Este aspecto adquiere particular jerarquía debido a que varios estudios epidemiológicos han hallado una correlación directa entre los niveles de hierro en plasma y la incidencia de cáncer o enfermedad coronaria

Oxygen, antioxidants and brain dysfunction

Brain is a logical target of free radical damage, considering the large lipid content of myelin sheaths and the high rate of brain oxidative metabolism. Thus, the hypothesis that free radicals may be involved in the pathogenesis of certain CNS diseases has gained increasing popularity in recent years. In CNS ischemia-reperfusion injury, the role of free radicals appears to be well established, however, involvement of other factors, such as excitatory amino acids and prostaglandins, may also contribute to the production of neuronal necrosis following ischemia. Liberation of free iron appears to play a crucial role in the generation of reactive oxygen species in posttraumatic epilepsy. Although there is no direct evidence to indicate free radical involvement in the pathogenesis of Alzheimer's disease, brain trauma with release of iron, amyloid angiopathy and disturbances in blood-brain barrier function all appear to contribute to the development of ischemic episodes with free radical generation and neuronal degeneration. In Parkinson's disease, the substantia nigra appears to be under oxidative stress as evidenced by the findings of increased lipid peroxidation, reduced GSH levels, high concentration of iron and free radical generation via autocatalytic mechanisms within neuromelanin-containing catecholaminergic neurons. Regardless of the initial insult, a cascade of events involving both reactive oxygen radicals and mitochondrial metabolism is likely to contribute to cell injury.

Evaluation of iron stores in acute lymphoplastic leukemia in children

Ineffective erythropoiesis and abnormal iron utilization had been noted in the development of anaemia in leukemic patients. Although serum ferritin is a valuable measurement for iron stores, yet it could not be used in disorders which are accompanied by abnormal increase in serum ferritin as in cases of acute leukemia and malignant lymphoma, and these disorders are better evaluated by iron staining in bone marrow biopsies. This rock is a trial to evaluate abnormalities of iron metabolism in acute lymphoblastic leukemia in children, and to study the possible utility of silver stain for bone marrow sideroblasts comparing to the pearl's reaction especially when the iron stores of the marrow ar elbow or absent. 20 cases of acute lymphoblastic leukemia in the acute phase, mean age [8.1 +/- 4.2] years. Were subjected to [1] thorough history and clinical examination. All cases were subjected to these investigations before taking chemotherapy [1] complete blood picture and blood indices [2] Serum iron and unsaturated iron binding capacity [3] Total iron binding capacity and transferrin saturation [4] Bone marrow aspiration and trephine biopsy and staining the specimens by pearl's reaction [Prussian blue] and modified silver stain. Our results showed a highly significant statistical difference in all cases versus the control group: A progressive decrease in the mean value of haemoglobin and packed call volume with P < 0.001. The MCV, MCH and MCHC were within normal levels. Increase in serum iron and transferrin saturation in the leukemic children with P < 0.001. Decrease in TIBC with [P < 0.01] in all children. The sensitivity of the modified silver staining method in detecting iron stores in the marrow of all patients was 95% in biopsy sections and the efficacy was 100% compared to the Pearl's stain, the sensitivity was 89% and the efficacy was 90%. The silver stain was proved to be more efficient