Subject(s)
Hemochromatosis/physiopathology , Iron Overload/physiopathology , Iron/metabolism , Hemochromatosis/history , Hemochromatosis/therapy , Hemochromatosis Protein , Hepcidins/physiology , Histocompatibility Antigens Class I/physiology , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Homeostasis/physiology , Humans , Iron Overload/history , Iron Overload/therapy , Membrane Proteins/physiologySubject(s)
Child Nutrition Sciences , Iron Metabolism Disorders , Iron Overload , Iron , Research Personnel , Child Nutrition Sciences/education , Child Nutrition Sciences/history , Erythropoiesis , History, 20th Century , Iron/history , Iron Metabolism Disorders/ethnology , Iron Metabolism Disorders/history , Iron Overload/ethnology , Iron Overload/history , Metabolism , Radioactivity , Research Personnel/education , Research Personnel/historySubject(s)
Aflatoxins , Black People , Carcinoma, Hepatocellular , Diet , Hepatitis B virus , Preventive Medicine , Aflatoxins/history , Black People/education , Black People/ethnology , Black People/history , Black People/legislation & jurisprudence , Black People/psychology , Carcinoma, Hepatocellular/ethnology , Carcinoma, Hepatocellular/history , Diet/ethnology , Diet/history , Hepatitis B, Chronic/ethnology , Hepatitis B, Chronic/history , Hepatitis C/ethnology , Hepatitis C/history , History, 20th Century , History, 21st Century , Humans , Iron Overload/ethnology , Iron Overload/history , Men's Health/ethnology , Men's Health/history , Preventive Health Services/history , Preventive Medicine/history , Vaccines/historySubject(s)
Drug Industry/history , Ethics/history , Interinstitutional Relations , Iron Chelating Agents/history , Publishing/history , Pyridones/history , Research Support as Topic/history , Universities/history , Canada , Confidentiality/history , Conflict of Interest , Deferiprone , Freedom , History, 20th Century , Hospitals, Pediatric/history , Humans , Iron Chelating Agents/adverse effects , Iron Chelating Agents/therapeutic use , Iron Overload/drug therapy , Iron Overload/history , Ontario , Publishing/legislation & jurisprudence , Pyridones/adverse effects , Pyridones/therapeutic use , Treatment FailureABSTRACT
Iron overload is common in rural sub-Saharan African populations that have the custom of drinking a traditional fermented beverage with high iron content. As with both excessive alcohol exposure and HFE hemochromatosis, hepatic portal fibrosis and micronodular cirrhosis are prominent sequelae of African iron overload. Two observations are therefore important in characterizing iron overload in Africa. First, the hepatic iron concentrations associated with African iron overload often far exceed those seen in alcoholic liver disease and histologic changes of alcohol effect are almost always absent. Second, the pattern of iron accumulation in African dietary iron is prominent in both macrophages and hepatic parenchymal cells; this pattern is in contrast to HFE homochromatosis, which is marked by predominantly parenchymal iron-loading. For a long time, it was thought that African iron overload was purely dietary in nature, that increased iron and alcohol in the diet could fully explain markedly elevated tissue iron levels sometimes seen with this condition. Recent studies of pedigrees suggest that, in addition to high dietary iron content, a genetic defect may also be implicated in iron overload in Africans. These studies indicate that the possible defect is different from mutations in the HFE gene frequently found in Caucasians with iron overload, but the putative gene has not been identified. Recent studies also indicate that non-HFE iron overload occurs in African-Americans, but the prevalence and possible genetic basis is yet to be determined.