BACKGROUND: Soluble transferrin receptor (sTfR) is generally unaffected by inflammatory status, whereas ferritin increases along with acute-phase proteins. The utility of these iron biomarkers in relation to inflammatory markers in children with sickle cell disease (SCD) with differing grades of severity is unclear. OBJECTIVES: To describe iron biomarker profiles and inflammatory responses in relation to disease severity in children with SCD. METHODS: This cross-sectional study describes plasma levels of sTfR, ferritin, C-reactive protein (CRP) and serum amyloid A (SAA) among 102 Yemeni children with SCD in relation to clinical profiles and disease severity. RESULTS: Median (IQR) sTfR was 58·5 mg/L (38-81), and concentration was positively correlated with reticulocyte count (r = +0·31, P = 0·002) and splenic enlargement (r = +0·20, P = 0·04), and was negatively correlated with Hb (r = -0·28, P = 0·004). Subcategories of children in a steady state were identified using ferritin and CRP cut-off values to discriminate iron status. In children in a steady state, the prevalence of iron deficiency was 25%, iron repletion 48% and marginal or normal status 27%. Ferritin concentration correlated positively with Hb and 23% of iron-deficient children had severe anaemia. CRP and SAA were increased in the steady state and were higher with acute disease complications (P<0·05 and <0·001, respectively). There was no association between sTfR or sTfR-ferritin index and inflammatory markers or disease severity score. CONCLUSION: In SCD, elevated sTfR is related to hypererythropoietic activity and does not correlate with inflammatory status or disease severity. Iron deficiency prevalence was estimated to be 25%. A classification of iron status is proposed.
BACKGROUND: Soluble transferrin receptor (sTfR) is generally unaffected by inflammatory status, whereas ferritin increases along with acute-phase proteins. The utility of these iron biomarkers in relation to inflammatory markers in children with sickle cell disease (SCD) with differing grades of severity is unclear. OBJECTIVES: To describe iron biomarker profiles and inflammatory responses in relation to disease severity in children with SCD. METHODS: This cross-sectional study describes plasma levels of sTfR, ferritin, C-reactive protein (CRP) and serum amyloid A (SAA) among 102 Yemeni children with SCD in relation to clinical profiles and disease severity. RESULTS: Median (IQR) sTfR was 58·5 mg/L (38-81), and concentration was positively correlated with reticulocyte count (r = +0·31, P = 0·002) and splenic enlargement (r = +0·20, P = 0·04), and was negatively correlated with Hb (r = -0·28, P = 0·004). Subcategories of children in a steady state were identified using ferritin and CRP cut-off values to discriminate iron status. In children in a steady state, the prevalence of iron deficiency was 25%, iron repletion 48% and marginal or normal status 27%. Ferritin concentration correlated positively with Hb and 23% of iron-deficient children had severe anaemia. CRP and SAA were increased in the steady state and were higher with acute disease complications (P<0·05 and <0·001, respectively). There was no association between sTfR or sTfR-ferritin index and inflammatory markers or disease severity score. CONCLUSION: In SCD, elevated sTfR is related to hypererythropoietic activity and does not correlate with inflammatory status or disease severity. Iron deficiency prevalence was estimated to be 25%. A classification of iron status is proposed.
Authors: Christopher R D'Adamo; James S Novick; Termeh M Feinberg; Valerie J Dawson; Larry E Miller Journal: J Am Coll Nutr Date: 2018-03-13 Impact factor: 3.169
Authors: Thassila N Pitanga; Sânzio S Santana; Dalila L Zanette; Caroline C Guarda; Rayra P Santiago; Vitor V Maffili; Jonilson B Lima; Graziele Q Carvalho; Jaime R Filho; Junia R D Ferreira; Milena M Aleluia; Valma M L Nascimento; Magda O S Carvalho; Isa M Lyra; Valéria M Borges; Ricardo R Oliveira; Marilda S Goncalves Journal: Inflamm Res Date: 2021-07-01 Impact factor: 4.575
Authors: Nathaniel Lee; Julie Makani; Furahini Tluway; Abel Makubi; Andrew E Armitage; Sant-Rayn Pasricha; Hal Drakesmith; Andrew M Prentice; Sharon E Cox Journal: EBioMedicine Date: 2018-07-25 Impact factor: 8.143