1.Irisin Attenuates Hepatic Stellate Cell Activation and Liver Fibrosis in Bile Duct Ligation Mice Model and Improves Mitochondrial Dysfunction
Thuy Linh LAI ; So Young PARK ; Giang NGUYEN ; Phuc Thi Minh PHAM ; Seon Mee KANG ; Jeana HONG ; Jae-Ho LEE ; Seung-Soon IM ; Dae-Hee CHOI ; Eun-Hee CHO
Endocrinology and Metabolism 2024;39(6):908-920
Background:
Liver fibrosis is a common outcome of chronic liver disease and is primarily driven by hepatic stellate cell (HSC) activation. Irisin, a myokine released during physical exercise, is beneficial for metabolic disorders and mitochondrial dysfunction. This study aimed to explore the effects of irisin on liver fibrosis in HSCs, a bile duct ligation (BDL) mouse model, and the associated mitochondrial dysfunction.
Methods:
In vitro experiments utilized LX-2 cells, a human HSC line, stimulated with transforming growth factor-β1 (TGF-β1), a major regulator of HSC fibrosis, with or without irisin. Mitochondrial function was assessed using mitochondrial fission markers, transmission electron microscopy, mitochondrial membrane potential, and adenosine triphosphate (ATP) production. In vivo, liver fibrosis was induced in mice via BDL, followed by daily intraperitoneal injections of irisin (100 μg/kg/day) for 10 days.
Results:
In vitro, irisin mitigated HSC activation and reduced reactive oxygen species associated with the TGF-β1/Smad signaling pathway. Irisin restored TGF-β1-induced increases in fission markers (Fis1, p-DRP1) and reversed the decreased expression of TFAM and SIRT3. Additionally, irisin restored mitochondrial membrane potential and ATP production lowered by TGF-β1 treatment. In vivo, irisin ameliorated the elevated liver-to-body weight ratio induced by BDL and alleviated liver fibrosis, as evidenced by Masson’s trichrome staining. Irisin also improved mitochondrial dysfunction induced by BDL surgery.
Conclusion
Irisin effectively attenuated HSC activation, ameliorated liver fibrosis in BDL mice, and improved associated mitochondrial dysfunction. These findings highlight the therapeutic potential of irisin for the treatment of liver fibrosis.
2.Irisin Attenuates Hepatic Stellate Cell Activation and Liver Fibrosis in Bile Duct Ligation Mice Model and Improves Mitochondrial Dysfunction
Thuy Linh LAI ; So Young PARK ; Giang NGUYEN ; Phuc Thi Minh PHAM ; Seon Mee KANG ; Jeana HONG ; Jae-Ho LEE ; Seung-Soon IM ; Dae-Hee CHOI ; Eun-Hee CHO
Endocrinology and Metabolism 2024;39(6):908-920
Background:
Liver fibrosis is a common outcome of chronic liver disease and is primarily driven by hepatic stellate cell (HSC) activation. Irisin, a myokine released during physical exercise, is beneficial for metabolic disorders and mitochondrial dysfunction. This study aimed to explore the effects of irisin on liver fibrosis in HSCs, a bile duct ligation (BDL) mouse model, and the associated mitochondrial dysfunction.
Methods:
In vitro experiments utilized LX-2 cells, a human HSC line, stimulated with transforming growth factor-β1 (TGF-β1), a major regulator of HSC fibrosis, with or without irisin. Mitochondrial function was assessed using mitochondrial fission markers, transmission electron microscopy, mitochondrial membrane potential, and adenosine triphosphate (ATP) production. In vivo, liver fibrosis was induced in mice via BDL, followed by daily intraperitoneal injections of irisin (100 μg/kg/day) for 10 days.
Results:
In vitro, irisin mitigated HSC activation and reduced reactive oxygen species associated with the TGF-β1/Smad signaling pathway. Irisin restored TGF-β1-induced increases in fission markers (Fis1, p-DRP1) and reversed the decreased expression of TFAM and SIRT3. Additionally, irisin restored mitochondrial membrane potential and ATP production lowered by TGF-β1 treatment. In vivo, irisin ameliorated the elevated liver-to-body weight ratio induced by BDL and alleviated liver fibrosis, as evidenced by Masson’s trichrome staining. Irisin also improved mitochondrial dysfunction induced by BDL surgery.
Conclusion
Irisin effectively attenuated HSC activation, ameliorated liver fibrosis in BDL mice, and improved associated mitochondrial dysfunction. These findings highlight the therapeutic potential of irisin for the treatment of liver fibrosis.
3.Irisin Attenuates Hepatic Stellate Cell Activation and Liver Fibrosis in Bile Duct Ligation Mice Model and Improves Mitochondrial Dysfunction
Thuy Linh LAI ; So Young PARK ; Giang NGUYEN ; Phuc Thi Minh PHAM ; Seon Mee KANG ; Jeana HONG ; Jae-Ho LEE ; Seung-Soon IM ; Dae-Hee CHOI ; Eun-Hee CHO
Endocrinology and Metabolism 2024;39(6):908-920
Background:
Liver fibrosis is a common outcome of chronic liver disease and is primarily driven by hepatic stellate cell (HSC) activation. Irisin, a myokine released during physical exercise, is beneficial for metabolic disorders and mitochondrial dysfunction. This study aimed to explore the effects of irisin on liver fibrosis in HSCs, a bile duct ligation (BDL) mouse model, and the associated mitochondrial dysfunction.
Methods:
In vitro experiments utilized LX-2 cells, a human HSC line, stimulated with transforming growth factor-β1 (TGF-β1), a major regulator of HSC fibrosis, with or without irisin. Mitochondrial function was assessed using mitochondrial fission markers, transmission electron microscopy, mitochondrial membrane potential, and adenosine triphosphate (ATP) production. In vivo, liver fibrosis was induced in mice via BDL, followed by daily intraperitoneal injections of irisin (100 μg/kg/day) for 10 days.
Results:
In vitro, irisin mitigated HSC activation and reduced reactive oxygen species associated with the TGF-β1/Smad signaling pathway. Irisin restored TGF-β1-induced increases in fission markers (Fis1, p-DRP1) and reversed the decreased expression of TFAM and SIRT3. Additionally, irisin restored mitochondrial membrane potential and ATP production lowered by TGF-β1 treatment. In vivo, irisin ameliorated the elevated liver-to-body weight ratio induced by BDL and alleviated liver fibrosis, as evidenced by Masson’s trichrome staining. Irisin also improved mitochondrial dysfunction induced by BDL surgery.
Conclusion
Irisin effectively attenuated HSC activation, ameliorated liver fibrosis in BDL mice, and improved associated mitochondrial dysfunction. These findings highlight the therapeutic potential of irisin for the treatment of liver fibrosis.
4.Irisin Attenuates Hepatic Stellate Cell Activation and Liver Fibrosis in Bile Duct Ligation Mice Model and Improves Mitochondrial Dysfunction
Thuy Linh LAI ; So Young PARK ; Giang NGUYEN ; Phuc Thi Minh PHAM ; Seon Mee KANG ; Jeana HONG ; Jae-Ho LEE ; Seung-Soon IM ; Dae-Hee CHOI ; Eun-Hee CHO
Endocrinology and Metabolism 2024;39(6):908-920
Background:
Liver fibrosis is a common outcome of chronic liver disease and is primarily driven by hepatic stellate cell (HSC) activation. Irisin, a myokine released during physical exercise, is beneficial for metabolic disorders and mitochondrial dysfunction. This study aimed to explore the effects of irisin on liver fibrosis in HSCs, a bile duct ligation (BDL) mouse model, and the associated mitochondrial dysfunction.
Methods:
In vitro experiments utilized LX-2 cells, a human HSC line, stimulated with transforming growth factor-β1 (TGF-β1), a major regulator of HSC fibrosis, with or without irisin. Mitochondrial function was assessed using mitochondrial fission markers, transmission electron microscopy, mitochondrial membrane potential, and adenosine triphosphate (ATP) production. In vivo, liver fibrosis was induced in mice via BDL, followed by daily intraperitoneal injections of irisin (100 μg/kg/day) for 10 days.
Results:
In vitro, irisin mitigated HSC activation and reduced reactive oxygen species associated with the TGF-β1/Smad signaling pathway. Irisin restored TGF-β1-induced increases in fission markers (Fis1, p-DRP1) and reversed the decreased expression of TFAM and SIRT3. Additionally, irisin restored mitochondrial membrane potential and ATP production lowered by TGF-β1 treatment. In vivo, irisin ameliorated the elevated liver-to-body weight ratio induced by BDL and alleviated liver fibrosis, as evidenced by Masson’s trichrome staining. Irisin also improved mitochondrial dysfunction induced by BDL surgery.
Conclusion
Irisin effectively attenuated HSC activation, ameliorated liver fibrosis in BDL mice, and improved associated mitochondrial dysfunction. These findings highlight the therapeutic potential of irisin for the treatment of liver fibrosis.
5.The application of an in situ karyotyping technique for mesenchymal stromal cells: a validation and comparison study with classical G-banding.
Sang Mee HWANG ; Cha Ja SEE ; Jungeun CHOI ; Seon Young KIM ; Qute CHOI ; Jung Ah KIM ; Jiseok KWON ; Si Nae PARK ; Kyongok IM ; Il Hoan OH ; Dong Soon LEE
Experimental & Molecular Medicine 2013;45(12):e68-
The cytogenetic analysis of mesenchymal stromal cells (MSCs) is essential for verifying the safety and stability of MSCs. An in situ technique, which uses cells grown on coverslips for karyotyping and minimizes cell manipulation, is the standard protocol for the chromosome analysis of amniotic fluids. Therefore, we applied the in situ karyotyping technique in MSCs and compared the quality of metaphases and karyotyping results with classical G-banding and chromosomal abnormalities with fluorescence in situ hybridization (FISH). Human adipose- and umbilical cord-derived MSC cell lines (American Type Culture Collection PCS-500-011, PCS-500-010) were used for evaluation. The quality of metaphases was assessed by analyzing the chromosome numbers in each metaphase, the overlaps of chromosomes and the mean length of chromosome 1. FISH was performed in the interphase nuclei of MSCs for 6q, 7q and 17q abnormalities and for the enumeration of chromosomes via oligo-FISH in adipose-derived MSCs. The number of chromosomes in each metaphase was more variable in classical G-banding. The overlap of chromosomes and the mean length of chromosome 1 as observed via in situ karyotyping were comparable to those of classical G-banding (P=0.218 and 0.674, respectively). Classical G-banding and in situ karyotyping by two personnel showed normal karyotypes for both cell lines in five passages. No numerical or structural chromosomal abnormalities were found by the interphase-FISH. In situ karyotyping showed equivalent karyotype results, and the quality of the metaphases was not inferior to classical G-banding. Thus, in situ karyotyping with minimized cell manipulation and the use of less cells would be useful for karyotyping MSCs.
Azure Stains
;
Chromosome Banding/*methods
;
Humans
;
In Situ Hybridization, Fluorescence/*methods
;
Karyotyping/*methods
;
Mesenchymal Stromal Cells/*cytology
6.The Clinical Significance of Specialized Intestinal Metaplasia in the Diagnosis of Barrett's Esophagus: Nationwide Prospective Multicenter Study.
Hyun Kyung PARK ; Nayoung KIM ; Byoung Hwan LEE ; Jin Il KIM ; So Young LEE ; Hyun Min CHA ; Hyerang KIM ; Soo Hyun PARK ; Jong Jae PARK ; Sang Woo LEE ; Ki Nam SHIM ; Seong Eun KIM ; Su Jin HONG ; Il Kwun CHUNG ; Gwang Ho BAIK ; Hyun Soo KIM ; Sungkook KIM ; Jae Kyu SEONG ; Geom Seog SEO ; Sam Ryong JEE ; Jeong Seop MOON ; Mee Yon CHO ; Jae Woo KIM ; Moon Gi CHUNG ; Seon Mee PARK ; Byung Kyu NAH ; Su Youn NAM ; Kang Seok SEO ; Byung Sung KO ; Yun Ju JO ; Jae Young JANG ; Byeong Gwan KIM ; Ji Won KIM ; Kyung Sik PARK ; Hyun Shin PARK ; Young Sun KIM ; Seon Hee LIM ; Chung Hyeon KIM ; Min Jung PARK ; Jeong Yoon YIM ; Kyung Ran CHO ; Donghee KIM ; Seun Ja PARK ; Geun Am SONG ; Hyun Jin KIM ; Sang Wook KIM ; Eui Hyeog IM ; Kyoung Soo LEE ; Dong Hyo HYUN ; Hyun Young KIM ; Sun Mi KIM ; Jeong Eun SHIN ; Chan Guk PARK ; Chang Hun YANG ; Soo Heon PARK ; Hyun Chae JUNG ; In Sik CHUNG
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(3):171-177
BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus
;
Biopsy
;
Chest Pain
;
Cough
;
Esophagus
;
Gastroesophageal Reflux
;
Heartburn
;
Hoarseness
;
Light
;
Metaplasia
;
Microscopy
;
Prospective Studies
;
Proton Pumps
;
Sensation
7.The Distribution of Endoscopic Gastritis in 25,536 Heath Check-up Subjects in Korea.
Hyun Kyung PARK ; Nayoung KIM ; Sang Woo LEE ; Jong Jae PARK ; Jin Il KIM ; So Young LEE ; Hyun Min CHA ; Hyerang KIM ; Soo Hyun PARK ; Ki Nam SHIM ; Seong Eun KIM ; Su Jin HONG ; Il Kwun CHUNG ; Gwang Ho BAIK ; Hyun Soo KIM ; Sungkook KIM ; Jae Kyu SEONG ; Geom Seog SEO ; Sam Ryong JEE ; Jeong Seop MOON ; Jae Woo KIM ; Moon Gi CHUNG ; Seon Mee PARK ; Byung Kyu NAH ; Su Youn NAM ; Kang Seok SEO ; Byung Sung KO ; Yun Ju JO ; Jae Young JANG ; Byeong Gwan KIM ; Ji Won KIM ; Kyung Sik PARK ; Hyun Shin PARK ; Young Sun KIM ; Seon Hee LIM ; Chung Hyeon KIM ; Min Jung PARK ; Jeong Yoon YIM ; Kyung Ran CHO ; Donghee KIM ; Seun Ja PARK ; Geun Am SONG ; Hyun Jin KIM ; Sang Wook KIM ; Eui Hyeog IM ; Kyoung Soo LEE ; Dong Hyo HYUN ; Hyun Young KIM ; Sun Mi KIM ; Jeong Eun SHIN ; Chan Guk PARK ; Chang Hun YANG ; Soo Heon PARK ; Hyun Chae JUNG ; In Sik CHUNG
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(4):237-243
BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia
;
Endoscopy
;
Female
;
Gastritis
;
Gastritis, Atrophic
;
Helicobacter pylori
;
Humans
;
Incidence
;
Korea
;
Male
;
Metaplasia
;
Peptic Ulcer
;
Prevalence
;
Stomach Neoplasms
8.The Distribution of Endoscopic Gastritis in 25,536 Heath Check-up Subjects in Korea.
Hyun Kyung PARK ; Nayoung KIM ; Sang Woo LEE ; Jong Jae PARK ; Jin Il KIM ; So Young LEE ; Hyun Min CHA ; Hyerang KIM ; Soo Hyun PARK ; Ki Nam SHIM ; Seong Eun KIM ; Su Jin HONG ; Il Kwun CHUNG ; Gwang Ho BAIK ; Hyun Soo KIM ; Sungkook KIM ; Jae Kyu SEONG ; Geom Seog SEO ; Sam Ryong JEE ; Jeong Seop MOON ; Jae Woo KIM ; Moon Gi CHUNG ; Seon Mee PARK ; Byung Kyu NAH ; Su Youn NAM ; Kang Seok SEO ; Byung Sung KO ; Yun Ju JO ; Jae Young JANG ; Byeong Gwan KIM ; Ji Won KIM ; Kyung Sik PARK ; Hyun Shin PARK ; Young Sun KIM ; Seon Hee LIM ; Chung Hyeon KIM ; Min Jung PARK ; Jeong Yoon YIM ; Kyung Ran CHO ; Donghee KIM ; Seun Ja PARK ; Geun Am SONG ; Hyun Jin KIM ; Sang Wook KIM ; Eui Hyeog IM ; Kyoung Soo LEE ; Dong Hyo HYUN ; Hyun Young KIM ; Sun Mi KIM ; Jeong Eun SHIN ; Chan Guk PARK ; Chang Hun YANG ; Soo Heon PARK ; Hyun Chae JUNG ; In Sik CHUNG
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(4):237-243
BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia
;
Endoscopy
;
Female
;
Gastritis
;
Gastritis, Atrophic
;
Helicobacter pylori
;
Humans
;
Incidence
;
Korea
;
Male
;
Metaplasia
;
Peptic Ulcer
;
Prevalence
;
Stomach Neoplasms
9.A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients.
Soo LIM ; So Youn KIM ; Jung Im KIM ; Min Kyung KWON ; Sei Jin MIN ; Soo Young YOO ; Seon Mee KANG ; Hong Il KIM ; Hye Seung JUNG ; Kyong Soo PARK ; Jun Oh RYU ; Hayley SHIN ; Hak Chul JANG
Diabetes & Metabolism Journal 2011;35(1):50-57
BACKGROUND: Advanced information technology can be used when developing diagnostic and treatment strategies to provide better care for diabetic patients. However, the levels of need and demand for the use of technological advances have not been investigated in diabetic patients. We proposed and developed an individualized, ubiquitous (U)-healthcare service using advanced information technology for more effective glucose control. Prior to our service initiation, we surveyed patient needs and other pertinent information. METHODS: During August 2009, we conducted a 34-item questionnaire survey among patients with diabetes who were older than 40 years in two certain hospitals in Korea. RESULTS: The mean age of the 228 participants was 61.2+/-9 years, and males made up 49.1% of the sample. Seventy-one percent replied that they wanted individualized healthcare service, and they also wanted their health information to be delivered through mobile devices such as a cellular phone or a personal digital assistant (40.4%). Most patients had never heard of U-healthcare services (81.1%); however, after explaining the concept, 71.1% of participants responded that they would use the service if it was provided. Despite their willingness, participants were concerned about technical difficulty in using the service (26.3%) as well as the cost of the service (29.8%). CONCLUSION: The current study suggests that more than 70% of diabetic patients are interested in using U-healthcare services. To encourage widespread use, the application program or device of U-healthcare services should be simple, easy to use and affordable while also including a policy for the protection of private information.
Blood Glucose
;
Cellular Phone
;
Computers, Handheld
;
Delivery of Health Care
;
Diabetes Mellitus
;
Glucose
;
Humans
;
Male
;
Surveys and Questionnaires
10.Hereditary Hemolytic Anemia in Korea: a Retrospective Study from 1997 to 2006.
Hee Soon CHO ; Jeong Ok HAH ; Im Ju KANG ; Hyung Jin KANG ; Jae Yong KWAK ; Hong Hoe KOO ; Hoon KOOK ; Byoung Kook KIM ; Soon Ki KIM ; Seung Taik KIM ; Young Dae KIM ; Ji Yoon KIM ; Chul Soo KIM ; Thad GHIM ; Heung Sik KIM ; Sang Gyu PARK ; Seon Yang PARK ; Jun Eun PARK ; Soo Mee BANG ; Jong Jin SEO ; Chang In SUH ; Sang Kyun SOHN ; Ho Jin SHIN ; Hee Young SHIN ; Hyo Sup AHN ; Doyeun OH ; Eun Sun YOO ; Chuhl Joo LYU ; Sung Soo YOON ; Kun Soo LEE ; Kwang Chul LEE ; Kee Hyun LEE ; Soon Yong LEE ; Young Ho LEE ; Jung Ae LEE ; Jong Seok LEE ; Young Tak LIM ; Jae Young LIM ; Ho Joon IM ; Dae Chul JEONG ; So Young CHONG ; Joo Seop CHUNG ; Hye Lim JUNG ; Goon Jae CHO ; Deog Yeon JO ; Jong Youl JIN ; Eun Jin CHOI ; Myung Soo HYUN ; Pyung Han HWANG
Korean Journal of Hematology 2007;42(3):197-205
BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult
;
alpha-Thalassemia
;
Anemia, Hemolytic, Congenital*
;
beta-Thalassemia
;
Bilirubin
;
Cell Membrane
;
Diagnosis
;
Elliptocytosis, Hereditary
;
Erythrocyte Indices
;
Female
;
Hemoglobinopathies
;
Humans
;
Internal Medicine
;
Jaundice
;
Korea*
;
L-Lactate Dehydrogenase
;
Male
;
Oxidoreductases
;
Pallor
;
Pathology, Molecular
;
Pediatrics
;
Phosphopyruvate Hydratase
;
Prevalence
;
Pyruvate Kinase
;
Reticulocyte Count
;
Retrospective Studies*
;
Sex Ratio
;
Surveys and Questionnaires

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