PURPOSE: Serum soluble transferrin receptor (sTfR) is a marker of iron deficiency and erythropoiesis. The purpose of this study is to evaluate the changes of iron parameters and sTfR in neonates by gestation; and to determine whether cord blood parameters for iron status and erythropoiesis are influenced by maternal iron deficiency or anemia. METHODS: Cord sTfR, iron and ferritin concentrations, hemoglobin (Hb), reticulocyte counts and total iron binding capacity were analyzed in 20 preterm and 60 term newborns. In term neonates, maternal iron status was classified by Hb and serum ferritin as anemic group (n=18; Hb < 11 g/dl and ferritin < 12 microgram/l), non-anemic group (n=14; Hb > or = 11 g/dl and ferritin < 12 microgram/l) and control (n=21, non anemic and non iron deficient). RESULTS: 1) Cord serum iron of preterm neonates was significantly lower than that of fullterm and the reticulocytes were significantly higher in preterm neonates. 2) The concentrations of cord serum iron were correlated positively with the gestational age, but other iron parameters and sTfR concentrations were not related to gestational age. The sTfR concentrations were correlated positively with cord blood hemoglobin. 3) Cord sTfR concentrations were significantly lower in newborns of anemic group compared with those of non-anemic group (P=0.03), or control (P=0.02). CONCLUSION: Cord sTfR was influenced by maternal iron deficiency aenmia, but not by maternal iron deficiency alone. Since sTfR reflects fetal erythropoietic activity, we speculate that low sTfR in newborns of iron deficiency anemic mother could suggest decreased fetal erythropoiesis by maternal anemia caused by iron depletion.
Anemia ; Erythropoiesis ; Ferritins ; Fetal Blood ; Gestational Age ; Humans ; Infant, Newborn* ; Iron* ; Mothers ; Pregnancy ; Receptors, Transferrin* ; Reticulocyte Count ; Reticulocytes ; Transferrin*

OBJECTIVETo establish and evaluate a protein microarray method for combined measurement of serum ferritin (SF) and soluble transferrin receptor (sTfR).

METHODSMicroarrayer was used to print both anti-SF antibodies I and anti-sTfR antibodies I on each protein microarray. Anti-SF antibodies II and anti-sTfR antibodies II were used as detection antibodies and goat antibodies coupled to Cy3 were used as antibodies III. The detection conditions of the quantitative analysis method for simultaneous measurement of SF and sTfR with protein microarray were optimized and evaluated. The protein microarray was compared with commercially available traditional tests with 26 serum samples.

RESULTSBy comparison experiment, mouse monoclonal antibodies were chosen as the probes and contact printing was chosen as the printing method. The concentrations of SF and sTfR probes were 0.5 mg/mL and 0.5 mg/mL respectively, while those of SF and sTfR detection antibodies were 5 μg/mL and 0.36 μg/mL respectively. Intra- and inter-assay variability was between 3.26% and 18.38% for all tests. The regression coefficients comparing protein microarray with traditional test assays were better than 0.81 for SF and sTfR.

CONCLUSIONThe present study has established a protein microarray method for combined measurement of SF and sTfR.

Animals ; Antibodies, Monoclonal ; analysis ; Ferritins ; blood ; Mice ; Protein Array Analysis ; methods ; Rabbits ; Receptors, Transferrin ; blood

This study was purposed to investigate the iron metabolism changes and their clinical significance in myelodysplastic syndrome (MDS). Thirty eight transfusion independent MDS patients and 49 controls (21 AA patients, 28 normal volunteers) were enrolled in this study. The iron metabolism indicators including serum iron protein (SF), serum iron (SI), transferrin protein (Tf), total iron binding capacity (TIBC), transferrin saturation (TS), soluble transferrin receptor (sTfR) were detected, the intracellular and extracellular iron distribution were observed under microscope, the chromosome karyotype was analysis by FISH. The results showed that the serum SF, SI and TS levels in MDS group were lower than those in AA group, the serum SF value was higher than that in normal control group. There was no statistical difference between the SI, TS levels as compared with normal control group. The SI, TS levels showed a positive correlation with SF level(r = 0.281, P = 0.007; r = 0.338, P = 0.001, respectively). The serum TIBC in MDS group was no statistically significant difference from that in the control group. The Tf level in MDS group was higher than that in AA and normal control groups, and Tf level between later 2 groups did not show statistical difference. The proportion of sideroblasts in MDS group (57.19 ± 19.11%)was higher than that in AA group (35.00 ± 20.67%). The extracellular iron (+ + +- + + + +) (24%)was lower than that in AA group (33%), and bone marrow particle dyeable iron displayed mainly cocci-like distribution under microscope in patients with increased extracellular iron (+ + +- + + + +), while small need or massive distribution was observed in AA group.In addition, the abnormal chromosome karyotype was found in 15 out of 19 MDS cases (79%). There was no difference in iron metabolism indicators between the high-risk group and the low-risk group of MDS divided according to the International Prognostic Scoring System (WPSS). It is concluded that the iron loading in transfusion-independent patients obviously increases, displaying the enhancement of SF, Tf, intra-and extra-cellular iron, but lower than those in AA patients. It suggests that the abnormality exists in process of use, storage and discharge of iron in MDS patients.
Adult ; Case-Control Studies ; Female ; Ferritins ; blood ; Hematopoiesis ; Humans ; Iron ; blood ; metabolism ; Male ; Middle Aged ; Myelodysplastic Syndromes ; blood ; metabolism ; physiopathology ; Receptors, Transferrin ; metabolism ; Transferrin ; metabolism

OBJECTIVETo study the prevalence of iron deficiency in children between 6 months and 7 years and to study the diagnostic value of soluble transferrin receptor (sTfR) for iron deficiency in the children.

METHODSA total of 502 healthy children between 6 months and 7 years from Hangzhou City of Zhejiang Province were enrolled. Serum sTfR, serum ferritin (SF), serum iron (SI), total iron blinding capacity (TIBC), zinc protoporphyrin (ZPP), Hb, MCV and CRP levels were measured.

RESULTSThe prevalence rate of iron deficiency was 19.5% in children at ages of 6 months to 7 years. The prevalence rate of iron deficiency was the highest in infants (≤1 year old; 34.7%), followed by in toddlers (1-3 years old; 19.4%) and preschoolers (3-7 years old; 14.0%). The mean serum sTfR level in infants (2.02±0.73 mg/L) was significantly higher than that in toddlers (1.68±0.40 mg/L) and preschoolers (1.67±0.29 mg/L) (P<0.05).The best cut-off value of serum sTfR for the diagnosis of iron deficiency was 2.02 mg/L in infants (sensitivity: 70.3%, specificity: 82.2%). The best cut-off value was 1.85 mg/L in toddlers (sensitivity: 71.7%; specificity: 86.4%), and that was 1.85 mg/L in preschoolers (sensitivity: 77.8%; specificity: 88.6%). Serum sTfR was correlated with SF (r=0.107, P<0.05), TIBC (r=0.276, P<0.01), TS (r=-0.139, P<0.05), ZPP (r=0.175, P<0.01) and MCV (r=-0.140, P<0.01).

CONCLUSIONSIron deficiency is more prevalent in infants ≤1 year old. The mean serum level and the cut-off value of sTfR in infants are higher than in toddlers and preschoolers. Serum sTfR is an effective index for the diagnosis of iron deficiency in children, especially in infants≤ 1 year old.

Age Factors ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Iron ; deficiency ; Male ; Prevalence ; Receptors, Transferrin ; blood

Animals ; Blood-Brain Barrier ; metabolism ; Ferritins ; metabolism ; Horses ; Mice ; Receptors, Transferrin ; metabolism ; Spleen ; chemistry

OBJECTIVETo investigate the systemic changes of iron metabolism following manganese exposure.

METHODSNinety-seven welders and 91 workers with no history of exposure to manganese were recruited from the same factory in Beijing serving as the exposure group and the control group respectively. The welding rods used were type J422. The concentration of the manganese in the air of the work place was determined respectively with the national standard method. The serum iron and manganese, ferritin, transferrin and transferrin receptors were measured with the graphite furnace atomic absorption spectrophotometry and ELISA in both groups.

RESULTSThe permissible concentration-STEL of ambient Mn in welders' breathing zone ranged from 0.53 mg/m(3) to 2.19 mg/m(3), while the permissible concentration-TWA of ambient Mn was between 0.29 mg/m(3) and 0.92 mg/m(3) in the breathing zone of the workplace. Serum Mn and Fe concentrations in welders were about 1.40 times (P < 0.0l) and 1.2 times (P < 0.01), respectively, higher than those of control subjects. At the same time, the transferrin concentrations in serum were significantly higher (about 1.2 times, P < 0.05) in welders than in controls. In contrast, transferrin receptors were significantly lower (about 1.2 times) in exposed subjects than controls (P = 0.001). There was no difference in serum ferritin between the two groups (P = 0.112). Although there was no significant trend, the serum ferritin level was increased by 18% in comparison with that of the control. The abnormal percentage of serum Fe and Serum Mn in welders were 55.67% and 67.01% respectively, higher than those of control subjects. In addition, the correlations between all indicators and the duration of employment were not observed.

CONCLUSIONThe long term exposure to the manganese can induce the disorder of the iron metabolism, which is found in the expression of increase of the serum iron and transferrin as well as the decrease of transferrin receptors.

Female ; Ferritins ; blood ; Humans ; Iron ; metabolism ; Iron Metabolism Disorders ; chemically induced ; Male ; Manganese ; adverse effects ; Occupational Exposure ; adverse effects ; Receptors, Transferrin ; blood ; Transferrin ; analysis ; Welding

BACKGROUND: In chronic renal failure (CRF) patients, iron deficiency is a common problem and a primary cause of resistance to recombinant human erythropoietin (rHuEPO) therapy. Serum ferritin and transferrin saturation (TS) are most commonly used parameters of iron status in CRF patients but may be influenced by the presence of inflammation and malnutrition. Recently soluble transfer-rin receptor (sTfR) has been advocated as a useful parameter of iron deficiency. We evaluated sTfR as an iron deficient marker in CRF patients. METHODS: Included in this study were 73 CRF patients, 30 uncomplicated iron deficiency anemia (IDA) patients, and 55 normal control. Serum sTfR, serum ferritin, TS, and complete blood count were measured. The CRF patients were classified as absolute iron deficient, functional iron deficient, non-iron deficient, and iron overload groups according to National Kidney Foundation Kidney Disease and Dialysis Outcome Quality Initiative (NKF-K/DOQI) guideline. RESULTS: The sTfR concentrations were significantly higher in uncomplicated IDA patients (3.9 +/-1.5 mg/L) and significantly lower in CRF patients (1.1 +/-0.4 mg/L) than in normal controls (1.4 +/-0.4mg/L). In uncomplicated IDA patients, sTfR was inversely correlated with MCV, MCH, and MCHC. In CRF patients, sTfR had a weak inverse correlation with TS and MCHC, but not significantly different between the four groups. The sTfR was not significantly different between the CRF patients with the normal CRP and those with an increased CRP. CONCLUSIONS: The sTfR is useful for diagnosis of uncomplicated IDA, but not for the detection of iron deficiency in CRF patients. Further studies are needed for the evaluation of sTfR as an erythro-poietic marker with rHuEPO therapy.
Anemia, Iron-Deficiency ; Blood Cell Count ; Diagnosis ; Dialysis ; Erythropoietin ; Ferritins* ; Humans ; Inflammation ; Iron ; Iron Overload ; Kidney ; Kidney Diseases ; Kidney Failure, Chronic* ; Malnutrition ; Receptors, Transferrin* ; Transferrin

OBJECTIVE: This study was aimed at investigating the usefulness of serum transferrin receptor (sTfR) in anemic patients with rheumatoid arthritis (RA) compared with bone marrow storage iron and other tests for anemia. METHODS: Fifty-five anemic RA patients were undergone anemia study including hematologic indices, iron panel, and sTfR. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. Eighteen patients performed marrow iron stain. The sTfR and serum ferritin levels were compared with bone marrow iron store, hematologic values, iron batteries, and markers of the disease activity. RESULTS: 1) Mean sTfR concentration was 2.68+/-1.29mg/L in all patients. 2) sTfR correlated significantly with hemoglobin concentration (r=-0.491; p<0.001), hematocrit (r=-0.348; p=0.009), MCV (r=-0.597; p<0.001), RDW (r=0.696; p<0.001), serum iron (r=-0.389; p=0.003), and transferrin saturation (r=-0.451; p=0.001) 3) Ferritin did not correlated significantly with hemoglobin, hematocrit, serum iron/TIBC, MCV and RDW, except reticulocyte count (r=0.295; p=0.032) and total iron binding capacity (TIBC) (r=-0.503; p<0.001). 4) sTfR showed no significant correlation with ESR and CRP, whereas ferritin correlated with CRP (r=0.342; p=0.019). 5) Among the patients who performed iron staining from bone marrow, sTfR was higher in ?ron-depleted? group compared with ?ron replete? group (p=0.040). CONCLUSION: This study suggests that measurement of sTfR may be useful assay for anemia and the possible substitute for invasive bone marrow study in differentiating iron deficiency anemia from anemia of chronic diseases in patients with RA.
Anemia* ; Anemia, Iron-Deficiency ; Arthritis, Rheumatoid* ; Blood Sedimentation ; Bone Marrow* ; C-Reactive Protein ; Chronic Disease ; Ferritins ; Hematocrit ; Humans ; Iron* ; Receptors, Transferrin* ; Reticulocyte Count ; Transferrin*

OBJECTIVE: This study was aimed at investigating the usefulness of serum transferrin receptor (sTfR) in anemic patients with rheumatoid arthritis (RA) compared with bone marrow storage iron and other tests for anemia. METHODS: Fifty-five anemic RA patients were undergone anemia study including hematologic indices, iron panel, and sTfR. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. Eighteen patients performed marrow iron stain. The sTfR and serum ferritin levels were compared with bone marrow iron store, hematologic values, iron batteries, and markers of the disease activity. RESULTS: 1) Mean sTfR concentration was 2.68+/-1.29mg/L in all patients. 2) sTfR correlated significantly with hemoglobin concentration (r=-0.491; p<0.001), hematocrit (r=-0.348; p=0.009), MCV (r=-0.597; p<0.001), RDW (r=0.696; p<0.001), serum iron (r=-0.389; p=0.003), and transferrin saturation (r=-0.451; p=0.001) 3) Ferritin did not correlated significantly with hemoglobin, hematocrit, serum iron/TIBC, MCV and RDW, except reticulocyte count (r=0.295; p=0.032) and total iron binding capacity (TIBC) (r=-0.503; p<0.001). 4) sTfR showed no significant correlation with ESR and CRP, whereas ferritin correlated with CRP (r=0.342; p=0.019). 5) Among the patients who performed iron staining from bone marrow, sTfR was higher in ?ron-depleted? group compared with ?ron replete? group (p=0.040). CONCLUSION: This study suggests that measurement of sTfR may be useful assay for anemia and the possible substitute for invasive bone marrow study in differentiating iron deficiency anemia from anemia of chronic diseases in patients with RA.
Anemia* ; Anemia, Iron-Deficiency ; Arthritis, Rheumatoid* ; Blood Sedimentation ; Bone Marrow* ; C-Reactive Protein ; Chronic Disease ; Ferritins ; Hematocrit ; Humans ; Iron* ; Receptors, Transferrin* ; Reticulocyte Count ; Transferrin*

Myelodysplastic syndrome (MDS) is a heterogeneous disease characterized by dysplasia and ineffective hematopoiesis. The dysplasia is crucial in the diagnosis of MDS, but the morphologic abnormalities of bone marrow cells are not specific for MDS. When the morphological evaluation of marrow dysplasia and cytogenetics can not give enough informations, for diagnosis of MDS, the application of flow cytometry (FCM) for immunophenotyping in MDS will become particularly important. Multiparametric evaluation of myeloid, monocytic maturation and antigen expression pattern contribute to the identification of two or more aberrancies in MDS cases. FCM evaluation of erythroid dysplasia is particularly difficult, because of the limited availability of specific markers. By analyzing the proteins involved in cellular iron metabolism, MDS erythroid cells present an "iron-loaded" phenotype characterized by increased ferritin contents and reduced transferrin receptor, which reflects the degree of dysplasia assessed by morphology. The proportion of CD34(+) cells increased, abnormal expression of surface antigen is also important. The application of flow cytometry in detecting dysplasia of myelodysplastic syndrome is discussed in this article.
Bone Marrow Cells ; pathology ; Erythroid Cells ; metabolism ; Flow Cytometry ; Humans ; Myelodysplastic Syndromes ; blood ; diagnosis ; pathology ; Receptors, Transferrin ; metabolism