Features of the secretion of interleukin-6, interleukin-1β, interferon-γ and their influence on the development of anemia of chronic diseases in patients with rheumatic pathology

Aim. To study the characteristics of interleukin-6 (IL-6), interleukin-1β(IL-1β), interferon-γ(INF-γ) secretion in rheumatic patients with and without anemia of chronic diseases. To assess the influence of these cytokines on the development of anemia of chronic iseases in patients with various rheumatic pathologies. To propose a working version of the classification of anemia of chronic diseases based on the leading pathogenetic factor in the development of anemia. Material and methods. 126 rheumatic patients, 34 men (45,8 (36–54,9) years old), 92 women (49,5 (38–60) years old) were examined. Group 1 included 41 patients with ACD, 34 with iron deficiency anemia (IDA). Group 2 had 29 patients with a combination of ACD and IDA, 22 in the control group without anemia. Comparative analysis between groups with and without anemia and correlation analysis of hemogram parameters, iron metabolism, C-reactive protein (CRP), interleukin-6 (IL-6), IL-1β, interferon gamma (INF-γ) were performed. Results. In the ACD group, the concentrations of ferritin, CRP, IL-6 were increased in comparison with other groups. With regard to IL-1β, INF-γ, no intergroup differences were found in the study groups (p>0,05). It was found that the greatest influence on the maturation of erythrocytes is exerted by INF-γ (r=-0,4). The greatest effect on hemoglobin synthesis is exerted by IL-6 (r=-0,6) and IL-1β (r=-0,4). The effect of the studied cytokines on erythropoiesis and hemoglobin synthesis can be realized through their effect on iron metabolism. This is confirmed by the results of the performed correlation analysis. A negative moderate correlation was shown between IL-6 and iron (r=-0,6), total iron binding capacity (TIBС)(r=-0,3), transferrin saturation index (TSI) (r=-0,5), ferritin (r=-0,5), transferrin (r=-0,3), and a moderately positive correlation with CRP (r=0,5). For INF-γ, a negative correlation was found with TIBC (r=-0,3), ferritin and transferrin (r=-0,3). For IL-1β, a moderate negative correlation was shown with TIBC, ferritin and transferrin (r=-0,4). Conclusion. It was found that patients with rheumatic pathology and anemia of chronic diseases had high concentration of IL-6, while the concentrations of INF-γ and IL-1β did not differ from the values in the groups of patients with IDA, a combination of AChD / IDA and without anemia. Despite this, the influence of all three investigated cytokines on erythropoiesis, hemoglobin synthesis and iron metabolism has been proven. The data obtained reflect the complex pathogenesis of ACD in patients with rheumatic pathology, including erythropoiesis disorders, changes in iron metabolism, and increased synthesis of some pro-inflammatory cytokines. A working version of the classification of ACD (with a predominant iron deficiency, with violations of the regulatory mechanisms of erythropoiesis, with insufficient production of erythropoietin) has been proposed.

THE EFFECTIVENESS OF STRUCTURED TEACHING MODULE ON PREVENTION OF ANAEMIA AMONG ADOLESCENT GIRLS

Anemia is a clinical condition that results from an insufficient supply of healthy red blood cells to oxygenate the body’s tissue adequately; results in hypoxia1 . It is a deficiency in the number of erythrocytes, the quantity of hemoglobin and or the volume of packed RBCs. Iron deficiency anemia is a condition due to decreased hemoglobin synthesis. It typically results when the intake of dietary iron is inadequate for hemoglobin synthesis. The findings of this study support the need for Community Health Nurse to conduct health education programme, to increase the knowledge of the adolescent girls regarding prevention of anaemia. Key words: Anemia, Adolescent Girl, Prevention, Knowledge

Vitamin B12 Status and Optimal Range for Hemoglobin Formation in Elite Athletes

Background: Athletes and coaches believe in the ergogenic effect of vitamin B12 (which results from enhanced erythropoiesis) and they often insist on its unjustified supplementation. Therefore, our study aimed to assess the vitamin B12 status in Polish elite athletes and its influence on red blood cell parameters. Methods: In total, 1131 blood samples were collected during six years from 243 track and field athletes divided into strength and endurance groups, as well as according to the declared use of vitamin B12 injections. Results: An average vitamin B12 concentration in all subjects was 739 ± 13 pg/mL, with no cases of deficiency. A weak but significant relationship was found between vitamin B12 and hemoglobin concentrations. A significant increase in hemoglobin appeared from very low vitamin B12 concentration and up to approx. 400 pg/mL, while hemoglobin did not significantly change from 700 pg/mL and onwards. Vitamin B12 injections were used by 34% of athletes, significantly more often by endurance than by strength athletes. In athletes who declared no use of injections, a higher concentration of vitamin B12 was observed in the endurance group. Conclusion: The main finding of the present study is the determination of the range of vitamin B12 concentration which may favor better hemoglobin synthesis in athletes. They should regularly monitor vitamin B12 concentration and maintain the range of 400–700 pg/mL as it may improve red blood cell parameters. We might suggest application of a supplementation if necessary. Special attention is required in athletes with a vitamin B12 concentration below 400 pg/mL.

Iron requirements in the first 2 years of life

Iron is an essential micronutrient required for hemoglobin synthesis, central nervous system development, and protection from infection. Early childhood is a time of vulnerability as iron deficiency in this period is associated with impaired neurodevelopment. Low socioeconomic status, preterm birth, and suboptimal diet are risk factors for iron deficiency. Due to a lack of iron excretory mechanism, the possibility of iron excess also exists. Appropriate iron intake in the first 2 years of life is critical.

Iron treatment of pregnant sows in a Danish herd without iron deficiency anemia did not improve sow and piglet hematology or stillbirth rate

Background Anemia characterized by low hemoglobin concentration (HbC) is common in indoor housed pregnant sows. Iron is essential for hemoglobin synthesis and a number of metabolic processes including DNA synthesis and regulation of enzyme systems. In sows, anemia has been linked to lower HbC in piglets and increased occurrence of stillbirths. Therefore, the main objective of this study was to evaluate the effect of iron injection on hematology of pregnant sows and their offspring. Other objectives were to evaluate the effect of this injection on the probability of stillbirths and to study the tolerability of injected iron. Results A sow herd with bi-weekly batch farrowing was selected for the study and 100 sows at mid-gestation were randomly assigned to either a treatment (FeT) or a control (FeC) group. At the time of recruitment to the study (baseline), 46% of the sows in the herd were anemic with a HbC less than 103 g/L. However, none of the anemic sows had iron deficiency anemia on erythrocyte characterization. HbC decreased numerically during gestation in both the FeT (− 2.48 g/L) and FeC (− 2.99 g/L) groups but the decrease was insignificant between the groups (P = 0.79). Likewise, the change from baseline to farrowing and from baseline to post-farrowing in other hematologic variables was similar for both groups. The percentage of transferrin saturation was not statistically different between groups (P = 0.14). There was a batch effect (week of breeding) in most of the hematologic variables. The probability of stillbirth in the two groups did not differ (P = 0.94). None of the hematologic variables in piglets was significantly different between the two groups. The sows tolerated the iron injection well. Conclusions Intramuscular injection of two doses of 2500 mg iron 2 weeks apart at mid-gestation did neither change hematologic variables in sows nor in the piglets at farrowing. Similarly, iron treatment did not reduce the probability of stillbirths among the offspring. The sows recruited in this study tolerated the iron injections well. Further characterization of erythrocytes did not support that sows had iron deficiency anemia at baseline. Therefore, further studies on animals with well-defined anemia and with focus on the iron regulating hormone hepcidin are recommended.

Nietypowy obraz hemoglobinopatii współistniejącej z talasemią β

Introduction. Inherited hemoglobin disorders, including thalassemia and hemoglobinopathies, are frequently occurring diseases in the world. Thalassemias are autosomal recessive disorders of hemoglobin synthesis. Underlying molecular defects in the α-globin or β-globin gene clusters form the basis of defective hemoglobin synthesis and the various inherited forms of α- halasemias or β-thalasemias. Thalassemia is diagnosted where hemoglobin levels, volume of red blood cells (MCV) and mean cellular hemoglobin (MCH) are significantly reduced. Aim. We want to introduce atypical clinical falieure of hemoglobinopathy. Material and methods. We presented two children with anemia. In first case it was a boy with normal MCV and reduced MCH, next case it was a girl after splenectomy with increased MCV and MCH. In both cases the red cells were hypochromic and also target cells were present in peripheral blood smear. Hemoglobin electrophoresis, measurement of HbA2 and HbF levels were performed. Results. Test results were characteristic for thalasemia β. Extending the diagnostic panel with genetic tests helped to identify in both of children thalassemia α silience carrier (-α/αα). In first case unstabile hemoglobin Hb Köln (Codon 98(295G > A)) was also detected and in second unstabile hemoglobin Hb Bruxelles (deletions del 42/β+). Conclusion. Only the genetic tests made it possible to explain atypical blood smear for thalassemia.