1.Novel perspective in transplantation therapy of mesenchymal stem cells: targeting the ferroptosis pathway.
Yuzhu XU ; Pan FAN ; Lei LIU ; X U XUANFEI ; Lele ZHANG ; Jiadong WANG ; Yuao TAO ; Xiaolong LI ; Xi LI ; Yuntao WANG
Journal of Zhejiang University. Science. B 2023;24(2):115-129
		                        		
		                        			
		                        			Ex vivo culture-amplified mesenchymal stem cells (MSCs) have been studied because of their capacity for healing tissue injury. MSC transplantation is a valid approach for promoting the repair of damaged tissues and replacement of lost cells or to safeguard surviving cells, but currently the efficiency of MSC transplantation is constrained by the extensive loss of MSCs during the short post-transplantation period. Hence, strategies to increase the efficacy of MSC treatment are urgently needed. Iron overload, reactive oxygen species deposition, and decreased antioxidant capacity suppress the proliferation and regeneration of MSCs, thereby hastening cell death. Notably, oxidative stress (OS) and deficient antioxidant defense induced by iron overload can result in ferroptosis. Ferroptosis may inhibit cell survival after MSC transplantation, thereby reducing clinical efficacy. In this review, we explore the role of ferroptosis in MSC performance. Given that little research has focused on ferroptosis in transplanted MSCs, further study is urgently needed to enhance the in vivo implantation, function, and duration of MSCs.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Antioxidants/metabolism*
		                        			;
		                        		
		                        			Ferroptosis
		                        			;
		                        		
		                        			Mesenchymal Stem Cell Transplantation
		                        			;
		                        		
		                        			Mesenchymal Stem Cells
		                        			;
		                        		
		                        			Iron Overload/metabolism*
		                        			
		                        		
		                        	
2.Luteoloside protects the vascular endothelium against iron overload injury via the ROS/ADMA/DDAH II/eNOS/NO pathway.
Shu-Ping CHEN ; Tian-Hong HU ; Qing ZHOU ; Tian-Peng CHEN ; Dong YIN ; Huan HE ; Qing HUANG ; Ming HE
Chinese Journal of Natural Medicines (English Ed.) 2022;20(1):22-32
		                        		
		                        			
		                        			Iron overload injury is considered to be a part of blood stasis syndrome of arthralgia in traditional Chinese medicine. Its primary therapies include clearing heat and detoxification, activating blood circulation, and removing blood stasis. Lonicera japonica flos (LJF) has long been known as an excellent antipyretic and antidote. Luteoloside (Lut) is one of the main components of LJF and exhibits antioxidant, anti-inflammatory, and cytoprotective properties. However, the protection of Lut against iron overload injury and its underlying mechanisms remain unclear. Therefore, HUVECs were exposed to 50 μmol·L-1 iron dextran for 48 h to establish an iron overload damage model and the effects of Lut were assessed. Our results showed that 20 μmol·L-1 Lut not only increased cell viability and weakened LDH activity, but also significantly up-regulated DDAHⅡ expression and activity, increased p-eNOS/eNOS ratio and NO content, and reduced ADMA content in HUVECs exposed to iron overload. Furthermore, Lut significantly attenuated intracellular/mitochondrial ROS generation, improved SOD, CAT, and GSH-Px activities, reduced MDA content, maintained MMP, inhibited mPTP opening, prevented cyt c from mitochondria released into cytoplasm, reduced cleaved-caspase3 expression, and ultimately decreased cell apoptosis induced by iron overload. The effects of Lut were similar to those of L-arginine (an ADMA competitive substrate), cyclosporin A (a mPTP blocker agent), and edaravone (a free radical scavenger) as positive controls. However, addition of pAD/DDAH II-shRNA adenovirus reversed the above beneficial effects of Lut. In conclusion, Lut can protect HUVECs against iron overload injury via the ROS/ADMA/DDAH II/eNOS/NO pathway. The mitochondria are the target organelles of Lut's protective effects.
		                        		
		                        		
		                        		
		                        			Endothelium, Vascular
		                        			;
		                        		
		                        			Glucosides
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			Luteolin
		                        			;
		                        		
		                        			Reactive Oxygen Species
		                        			
		                        		
		                        	
3.Influencing factors of iron metabolism assessment in patients with myelodysplastic syndrome: A retrospective study.
Yao ZHANG ; Chao XIAO ; Jing LI ; Lu Xi SONG ; You Shan ZHAO ; Jun Gong ZHAO ; Chun Kang CHANG
Chinese Journal of Hematology 2022;43(4):293-299
		                        		
		                        			
		                        			Objective: To analyze the influencing factors of iron metabolism assessment in patients with myelodysplastic syndrome. Methods: MRI and/or DECT were used to detect liver and cardiac iron content in 181 patients with MDS, among whom, 41 received regular iron chelation therapy during two examinations. The adjusted ferritin (ASF) , erythropoietin (EPO) , cardiac function, liver transaminase, hepatitis antibody, and peripheral blood T cell polarization were detected and the results of myelofibrosis, splenomegaly, and cyclosporine were collected and comparative analyzed in patients. Results: We observed a positive correlation between liver iron concentration and ASF both in the MRI group and DECT groups (r=0.512 and 0.606, respectively, P<0.001) , only a weak correlation between the heart iron concentration and ASF in the MRI group (r=0.303, P<0.001) , and no significant correlation between cardiac iron concentration and ASF in the DECT group (r=0.231, P=0.053) . Moreover, transfusion dependence in liver and cardiac [MRI group was significantly associated with the concentration of iron in: LIC: (28.370±10.706) mg/g vs (7.593±3.508) mg/g, t=24.30, P<0.001; MIC: 1.81 vs 0.95, z=2.625, P<0.05; DECT group: liver VIC: (4.269±1.258) g/L vs (1.078±0.383) g/L, t=23.14, P<0.001: cardiac VIC: 1.69 vs 0.68, z=3.142, P<0.05]. The concentration of EPO in the severe iron overload group was significantly higher than that in the mild to moderate iron overload group and normal group (P<0.001) . Compared to the low-risk MDS group, the liver iron concentration in patients with MDS with cyclic sideroblasts (MDS-RS) was significantly elevated [DECT group: 3.80 (1.97, 5.51) g/L vs 1.66 (0.67, 2.94) g/L, P=0.004; MRI group: 13.7 (8.1,29.1) mg/g vs 11.6 (7.1,21.1) mg/g, P=0.032]. Factors including age, bone marrow fibrosis, splenomegaly, T cell polarization, use of cyclosporine A, liver aminotransferase, and hepatitis antibody positive had no obvious effect on iron metabolism. Conclusion: There was a positive correlation between liver iron concentration and ASF in patients with MDS, whereas there was no significant correlation between cardiac iron concentration and ASF. Iron metabolism was affected by transfusion dependence, EPO concentration, and RS.
		                        		
		                        		
		                        		
		                        			Ferritins
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Iron
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			Liver/metabolism*
		                        			;
		                        		
		                        			Myelodysplastic Syndromes/therapy*
		                        			;
		                        		
		                        			Primary Myelofibrosis
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Splenomegaly
		                        			
		                        		
		                        	
4.Recommendations of EASL clinical practice guidelines on haemochromatosis.
Shan TANG ; Su Jun ZHENG ; Zhong Ping DUAN
Chinese Journal of Hepatology 2022;30(9):934-938
		                        		
		                        			
		                        			Haemochromatosis is characterised by elevated transferrin saturation (TSAT) and progressive iron loading that mainly affects the liver. Early diagnosis and treatment by phlebotomy can prevent cirrhosis, hepatocellular carcinoma, diabetes, arthropathy and other complications. In patients homozygous for p.Cys282Tyr in HFE, provisional iron overload based on serum iron parameters (TSAT >45% and ferritin >200 μg/L in females and TSAT >50% and ferritin >300 μg/L in males and postmenopausal women) is sufficient to diagnose haemochromatosis. In patients with high TSAT and elevated ferritin but other HFE genotypes, diagnosis requires the presence of hepatic iron overload on MRI or liver biopsy. The stage of liver fibrosis and other end-organ damage should be carefully assessed at diagnosis because they determine disease management. Patients with advanced fibrosis should be included in a screening programme for hepatocellular carcinoma. Treatment targets for phlebotomy are ferritin <50 μg/L during the induction phase and <100 μg/L during the maintenance phase.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hemochromatosis/therapy*
		                        			;
		                        		
		                        			Hemochromatosis Protein/genetics*
		                        			;
		                        		
		                        			Carcinoma, Hepatocellular/complications*
		                        			;
		                        		
		                        			Iron Overload/genetics*
		                        			;
		                        		
		                        			Ferritins
		                        			;
		                        		
		                        			Liver Cirrhosis/complications*
		                        			;
		                        		
		                        			Iron
		                        			;
		                        		
		                        			Fibrosis
		                        			;
		                        		
		                        			Liver Neoplasms/complications*
		                        			;
		                        		
		                        			Transferrins
		                        			
		                        		
		                        	
5.Establishment of an Iron-overloaded Mouse Model with Tuberculosis and Analysis of the Iron Metabolism Index.
Jun-Li LI ; Ya-Nan SHI ; Ling-Jun ZHAN
Acta Academiae Medicinae Sinicae 2021;43(3):357-365
		                        		
		                        			
		                        			Objective To establish a mouse model of exogenous iron overload combined with tuberculosis(TB). Methods C57BL/6N mice were divided into negative control, low-, medium-, and high-dose iron groups and received intraperitoneal injection of iron dextran at 0, 3.75, 7.50, and 15.00 mg/dose(3 times/week for 4 weeks), respectively.After 4 weeks, the organ morphology and body weight of the mice were evaluated.The content of serum iron, ferritin, transferrin, and transferrin receptor was determined by ELISA.Heart, liver, spleen, lung, kidney, and small intestine were analyzed for tissue iron content and iron deposition pathology.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Iron
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			Iron-Dextran Complex
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Mice, Inbred C57BL
		                        			;
		                        		
		                        			Tuberculosis
		                        			
		                        		
		                        	
6.Research progress of iron metabolism in phenotype modification of β-thalassemia.
Chinese Journal of Medical Genetics 2021;38(1):27-31
		                        		
		                        			
		                        			β-thalassemia is a type of inherited hemolytic anemia caused by decreased globin production due to defect of the HBB gene. The pathogenesis of the disease is imbalance of α/β globin chains. The excess of α-globin chains will form hemichromes which can damage red blood cell membranes and lead to hemolysis, ineffective erythropoiesis, and secondary iron overload. Iron overload in turn can cause complications such as growth retardation, liver cirrhosis, cardiac insufficiency, and aggravate the disease phenotype. In recent decades, genes participating in iron metabolism have been discovered, and the mechanism of iron metabolism in the development of thalassemia has gradually been elucidated. Subsequently, by manipulating the expression of key genes in iron metabolism such as hepcidin and transferrin receptor, researchers have revealed that iron restriction can improve ineffective hematopoiesis and iron overload, which may provide a potential approach for the treatment of thalassemia. This article reviews the progress of research on iron metabolism-related genes and related pathways in β-thalassemia.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Iron/metabolism*
		                        			;
		                        		
		                        			Iron Overload/genetics*
		                        			;
		                        		
		                        			Phenotype
		                        			;
		                        		
		                        			Research/trends*
		                        			;
		                        		
		                        			beta-Thalassemia/physiopathology*
		                        			
		                        		
		                        	
7.Prevalence Rate and Risk Factors of Hypothyroidism in Children with Beta Thalassemia Major in Zhuhai Area.
Mo CHEN ; Li DUAN ; Chuan-Xin ZHOU ; Jian-Pei FANG
Journal of Experimental Hematology 2021;29(6):1881-1886
		                        		
		                        			OBJECTIVE:
		                        			To investigate the prevalence rate of hypothyroidism in children with β-thalassemia major (β-TM) and its risk factors.
		                        		
		                        			METHODS:
		                        			A total of 86 children with β-TM treated and followed up in the Department of Pediatrics of the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai Municipal Maternal and Child Health Care Hospital from August 2018 to August 2020 were enrolled. The clinical data of the children were analyzed to investigate the prevalence rate of hypothyroidism in children with β-thalassemia major (β-TM) and its risk factors.
		                        		
		                        			RESULTS:
		                        			The prevalence rate of hypothyroidism in children with β-TM in Zhuhai area was 17.4%. The level of serum ferritin(SF) (4948.27±1225.33 μg/L) in hypothyroidism children was significantly increased(t=10.273,P<0.05). The prevalence rate of hypothyroidism was significantly higher in β-TM children(age ≥10 years old, SF ≥2 500 μg/L and irregular iron removal) (P<0.05). Logistic regression result showed that age ≥10 years old was the independent risk factor affecting the increasing of hypothyroidism rate in the children. The levels of SF(3880.60±1269.17 μg/L), TSH(4.43±1.52 mIU/L) and the prevalence rate of hypothyroidism(37.14%)(P<0.05) were higher for the children in irregular iron removal group.
		                        		
		                        			CONCLUSION
		                        			The prevalence rate of hypothyroidism in children with β-TM in Zhuhai area is high, and it is related to the age ≥10 years old, SF ≥2 500 μg/L and irregular iron removal of the children.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypothyroidism/epidemiology*
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			beta-Thalassemia/epidemiology*
		                        			
		                        		
		                        	
8.Change of Hepcidin in Patients with Iron Overload at the Tibet Plateau.
Shu-Yao SUN ; Su-Yuan WANG ; Zeng-Mei SUN ; Ming-Xia LI ; Yun-Hong WU
Journal of Experimental Hematology 2020;28(4):1406-1409
		                        		
		                        			OBJECTIVE:
		                        			To explore the possible etiological factors of iron overload through detecting plasma hepcidin level of adult males at Tibet plateau.
		                        		
		                        			METHODS:
		                        			81 Tibetan male adult patients hospitalized in our department during January 2017 - December 2018 were selected, and divided into iron overload group and non-iron overload group. The difference in serum ferritin, serum iron, total iron binding capacity, hemoglobin, HBSAg, ALT, AST, albumin, creatinine and hepcidin of patients in each group were tested. To analyze the differences between groups. The regression analysis was applied to analyze the relationship between laboratory index and hepcidin.
		                        		
		                        			RESULTS:
		                        			The plasma hepcidin of iron overload group was significantly higher than that of the non-iron overload group [93.69 (65.57-133.92) ng/ml vs 63.93 (40.01-90.65) ng/ml] (P=0.005). And there was a positive correlation between plasma hepcidin and ferritin (β=0.03 ng/ml,95%CI 0.01-0.05) (P<0.01) and BMI (β=5.71 ng/ml,95%CI 0.54-10.88) (P<0.05).
		                        		
		                        			CONCLUSION
		                        			Iron overload at Tibet plateau can not be attributed to hepcidin deficiency in Tibetan adult male patients. Iron metabolism disorders in Tibetan population may be associated with metabolic syndrome.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Ferritins
		                        			;
		                        		
		                        			Hepcidins
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Iron
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Tibet
		                        			
		                        		
		                        	
9.Analysis of HFE and Non-HFE Mutations in a Tibet Cohort with Iron Overload.
Shu-Yao SUN ; Yan-Hong GUO ; Zeng-Mei SUN ; Yun-Hong WU ; Ming-Xia LI
Journal of Experimental Hematology 2019;27(2):618-622
		                        		
		                        			OBJECTIVE:
		                        			The explore the molecular basis of iron-overload in Tibet nationality population of Tibet.
		                        		
		                        			METHODS:
		                        			The inpatients with iron-overload in our department from Dec. 1st 2014 to Jul.31st 2016 were enrolled in this study. Abdominal MRI and the mutation sites C282Y and H63D in HFE exon were examined. For HFE mutation-negative patients, the non-HFE mutation was detected, including 5 HJV mutations of G320V, p.Q312X, p.D249H, p.I281T, p.C321X and 2 TFR2 mutations: (Y250X, I238M), and 2 SLC40A1 mutations: (V162del, N144H).
		                        		
		                        			RESULTS:
		                        			Among 113 iron overload patients, only one showed homozygous p.H63D mutation, and one showed heterozygosis p.H63D mutation. In 73 patients accepted non-HFE gene detection, only one was heterozygosis p.D249N mutation in HJV, and one was heterozygosis p.I238M mutation in TFR2.
		                        		
		                        			CONCLUSION
		                        			Currently, the pathogenic gene for Tibetan iron-overload has not yet been found.
		                        		
		                        		
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Hemochromatosis Protein
		                        			;
		                        		
		                        			Histocompatibility Antigens Class I
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Tibet
		                        			
		                        		
		                        	
10.Ferroptosis was involved in the oleic acid-induced acute lung injury in mice.
Hang ZHOU ; Feng LI ; Jian-Yi NIU ; Wei-Yong ZHONG ; Min-Yu TANG ; Dong LIN ; Hong-Hui CUI ; Xue-Han HUANG ; Ying-Ying CHEN ; Hong-Yan WANG ; Yong-Sheng TU
Acta Physiologica Sinica 2019;71(5):689-697
		                        		
		                        			
		                        			The aim of the present study was to investigate the role of ferroptosis in acute lung injury (ALI) mouse model induced by oleic acid (OA). ALI was induced in the mice via the lateral tail vein injection of pure OA. The histopathological score of lung, lung wet-dry weight ratio and the protein content of bronchoalveolar lavage fluid (BALF) were used as the evaluation indexes of ALI. Iron concentration, glutathione (GSH) and malondialdehyde (MDA) contents in the lung tissues were measured using corresponding assay kits. The ultrastructure of pulmonary cells was observed by transmission electron microscope (TEM), and the expression level of prostaglandin-endoperoxide synthase 2 (PTGS2) mRNA was detected by quantitative polymerase chain reaction (q-PCR). Protein expression levels of glutathione peroxidase 4 (GPX4), ferritin and transferrin receptor 1 (TfR1) in lung tissues were determined by Western blot. The results showed that histopathological scores of lung tissues, lung wet-dry weight ratio and protein in BALF in the OA group were higher than those of the control group. In the OA group, the mitochondria of pulmonary cells were shrunken, and the mitochondrial membrane was ruptured. The expression level of PTGS2 mRNA in the OA group was seven folds over that in the control group. Iron overload, GSH depletion and accumulation of MDA were observed in the OA group. Compared with the control group, the protein expression levels of GPX4 and ferritin in lung tissue were down-regulated in the OA group. These results suggest that ferroptosis plays a potential role in the pathogenesis of ALI in our mouse model, which may provide new insights for development of new drugs for ALI.
		                        		
		                        		
		                        		
		                        			Acute Lung Injury
		                        			;
		                        		
		                        			chemically induced
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Apoptosis
		                        			;
		                        		
		                        			Bronchoalveolar Lavage Fluid
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Cyclooxygenase 2
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Ferritins
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Glutathione
		                        			;
		                        		
		                        			analysis
		                        			;
		                        		
		                        			Glutathione Peroxidase
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Iron
		                        			;
		                        		
		                        			analysis
		                        			;
		                        		
		                        			Iron Overload
		                        			;
		                        		
		                        			physiopathology
		                        			;
		                        		
		                        			Lung
		                        			;
		                        		
		                        			cytology
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Malondialdehyde
		                        			;
		                        		
		                        			analysis
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Microscopy, Electron, Transmission
		                        			;
		                        		
		                        			Mitochondrial Membranes
		                        			;
		                        		
		                        			ultrastructure
		                        			;
		                        		
		                        			Oleic Acid
		                        			
		                        		
		                        	
            
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