CD200 expression in hematopoietic neoplasms: Beyond a marker for diagnosis of B-cell neoplasms.

CD200 (OX-2) is expressed in myeloid cells, B cells, subsets of T cells and on other normal and neoplastic non-hematopoietic cells. It interacts with CD200R and has a suppressive effect on T cells immune mediated response. We aimed to review CD200 expression and its role in the immune evasion of non-B cell hematopoietic neoplasms. In acute myeloid leukemia, CD200 seems to be related to the worst outcome, even in diseases of good prognosis, possibly due to an immunosuppressive effect. In plasma cell myeloma studies, while some have associated CD200 expression with worst prognosis possibly due to its suppressive effect on monocyte and T cell-mediated immune response, in others CD200 appeared to be a marker of a better outcome, or even showed no impact in event-free survival (EFS). Few studies have evaluated CD200 expression in T cell neoplasms; however, it appears to be a good immunophenotypic marker for angioimmunoblastic T cell lymphoma. In conclusion, CD200 appears to be involved in the immune evasion of malignant cells, which could affect the survival of these patients.

Hepcidin is a useful biomarker to evaluate hyperferritinemia associated with metabolic syndrome.

Investigation of hyperferritinemia in metabolic syndrome patients represents a diagnostic challenge, but it is essential for the identification of individuals with iron overload. Hepcidin negatively regulates iron absorption and release. An increase in hepcidin occurs when iron levels are sufficient or in inflammatory states, conditions often associated with hyperferritinemia. Hemochromatosis causes hyperferritinemia due to iron overload, but frequently has low hepcidin levels. Our aim was to evaluate biochemical and molecular parameters related to iron metabolism in patients with metabolic syndrome. We evaluated 94 patients with metabolic syndrome according to the International Diabetes Federation criteria in a cross-sectional study. Anthropometric data and diagnostic criteria for metabolic syndrome, iron dosage, ferritin, transferrin saturation, hepcidin, and the C282Y and H63D mutations in the HFE hemochromatosis gene were evaluated. Prevalence of hyperferritinemia in the study population was 27.7% and was higher in males (46.2%) than in females (14.5%). Increase in transferrin saturation correlated with mutations in the hemochromatosis gene. Hyperferritinemia was associated to transferrin saturation and hepcidin after logistic regression analysis. In conclusion, hyperferritinemia is a frequent finding in metabolic syndrome patients, most frequently in men; and hepcidin assessment can be useful for the investigation of ferritin increase in those subjects.

Prevalence of low bone mineral density in adolescents and adults with cystic fibrosis.

OBJECTIVE: The aim of this cross-sectional study was to evaluate the prevalence of low bone mass density in cystic fibrosis patients as well as to evaluate the factors associated with bone mass in such patients. METHODS: Bone mass density was measured by dual-photon X-ray absorptiometry of lumbar spine (L1-L4), in patients ≤19 years old, or lumbar spine and femur (total and neck) in patients ≥20 years old. Evaluations of nutritional status, biochemical parameters, and lung function were performed. Medication data were obtained from medical records. RESULTS: Fifty-eight patients were included in the study (25 males/ 33 females), mean age 23.9 years (16-53 years). The prevalence of bone mass below the expected range for age at any site was 20.7%. None of the subjects had history of fracture. Lumbar spine Z-score in cystic fibrosis patients correlated positively with body mass index (r= 0.3, p=0.001), and forced expiratory volume in the first second (% predicted) (r=0.415, p=0.022). Mean lumbar spine Z-score was higher in women (p=0.001), in patients with no pancreatic insufficiency (p=0.032), and in patients with no hospitalization in the last 3 months (p=0.02). After multivariate analysis, body mass index (p= 0.001) and sex (p=0.001) were independently associated with Z-score in lumbar spine. CONCLUSION: Low bone mass is a frequent problem in patients with CF, being independently associated with body mass index, and male sex.

Prevalence of low bone mineral density in adolescents and adults with cystic fibrosis / Prevalência de densidade mineral óssea baixa em adolescentes e adultos com fibrose cística

Objective The aim of this cross-sectional study was to evaluate the prevalence of low bone mass density in cystic fibrosis patients as well as to evaluate the factors associated with bone mass in such patients. Methods Bone mass density was measured by dual-photon X-ray absorptiometry of lumbar spine (L1-L4), in patients ≤19 years old, or lumbar spine and femur (total and neck) in patients ≥20 years old. Evaluations of nutritional status, biochemical parameters, and lung function were performed. Medication data were obtained from medical records. Results Fifty-eight patients were included in the study (25 males/ 33 females), mean age 23.9 years (16-53years). The prevalence of bone mass below the expected range for age at any site was 20.7%. None of the subjects had history of fracture. Lumbar spine Z-score in cystic fibrosis patients correlated positively with body mass index (r= 0.3, p=0.001), and forced expiratory volume in the first second (% predicted) (r=0.415, p=0.022). Mean lumbar spine Z-score was higher in women (p=0.001), in patients with no pancreatic insufficiency (p=0.032), and in patients with no hospitalization in the last 3 months (p=0.02). After multivariate analysis, body mass index (p= 0.001) and sex (p=0.001) were independently associated with Z-score in lumbar spine. Conclusion Low bone mass is a frequent problem in patients with CF, being independently associated with body mass index, and male sex. .

Objetivo Determinar a prevalência de massa óssea baixa em pacientes adolescentes e adultos com fibrose cística e estudar os fatores potencialmente associados. Métodos Densidade mineral óssea foi determinada por absorciometria por dupla emissão de raios X na coluna lombar em pacientes ≤ 19 anos e na coluna e no fêmur em pacientes ≥ 20 anos. Avaliações nutricionais, bioquímicas e pulmonares foram realizadas. Dados referentes ao tratamento farmacológico foram coletados. Resultados 58 pacientes foram incluídos no estudo (25 homens/33 mulheres), média de idade de 23,9 anos (16-53). Massa óssea abaixo da esperada foi verificada em 20,7% dos pacientes. Não houve histórico de fratura. Z-score da coluna lombar associou-se positivamente com índice de massa corporal (r=0,3; p=0,022), volume expiratório forçado (% previsto) (r=0,415; p=0,001). A média do Z-score da coluna foi mais alta nas mulheres que nos homens (p=0,001), em pacientes que não possuíam insuficiência pancreática (p=0,02) e em pacientes que não haviam sido hospitalizados nos últimos três meses (p=0,032). Os fatores encontrados como preditores independentes de Z-score da coluna lombar foram sexo masculino (p=0,001) e índice de massa corporal (p=0,001). Conclusão Massa óssea baixa é frequente em pacientes com FC, estando associada independentemente com índice de massa corporal e sexo masculino. .