Iron store and free radicals in thalassemia

Hyper-ferrous state is the result of multiple transfusions, whereby the iron excess in such conditions may be toxic to the organism. Patients suffering from thalassemia receive multiple transfusions. In the eastern part of India, both β⁰-thalassemia and heterozygous Eβ-thalassemia occur. This paper expresses the hyper-ferrous state, leading to iron overload in these two conditions and also reports the increased generation of free radicals, consequent to the iron overload.     

Relationship between free iron and glycated hemoglobin in uncontrolled type 2 diabetes patients associated with complications

Free iron in serum has been found in several disease conditions including diabetes. In the present work, we studied the relationship between free iron, fasting blood glucose (FBG) and glycated haemoglobin (HbA_1c). Study was carried out on 50 type 2 diabetes cases under poor glycemic control associated with complications, 53 type 2 diabetes cases under good glycemic control and 40 healthy controls. We estimated free iron, both ferrous (Fe⁺²) and ferric (Fe⁺³) form, protein thiols, lipid hydroperoxides, FBG, HbA1c and serum ferritin levels in serum. There was a significant increase in free iron in Fe⁺³ state (p <0.01), HbA_1c (p<0.01), serum ferritin (p<0.01), lipid hydroperoxides (p<0.01) and significant decrease in protein thiols (<0.01) in diabetes cases under poor glycemic control compared to diabetes cases under good glycemic control and healthy controls. Free iron correlated positively with HbA_1c (p<0.01). Poor glycemic control and increase in glycation of haemoglobin is contributing to the increase in free iron pool which is known to increase oxidant generation.     

Potential Biochemical Markers for Preterm Labor: A Pilot Study in North India

Preterm delivery is a major contributor for neonatal mortality. Intensive research is underway to establish a reliable biomarker that can ascertain the risk of preterm delivery in pregnant women. The aim of our study was to evaluate the role of various biochemical parameters as potential biomarker for risk assessment for preterm labor. Forty women presenting with preterm labor and 40 women who delivered at term were included in the study. Parameters that were evaluated include corticotrophin (ACTH), prolactin, thyroid stimulating hormone (TSH), ferritin and Alkaline Phosphatase (ALP). Serum ACTH, ferritin, ALP and Ferritin/Iron ratio were significantly higher in the subjects who delivered prematurely as compared to the controls. Comparison of sensitivity, specificity, likelihood ratio, positive and negative predictive values for different cut offs for ACTH, ferritin, ALP and ferritin/iron ratio was carried out. Ferritin emerged as the best marker with area under curve of 0.96 as compared to 0.88 for ACTH, 0.825 for ALP and 0.735 for ferritin/iron ratio. Our study establishes the superiority of ferritin as a predictive biomarker for preterm labor as compared to the rest of the parameters evaluated.     

Hyperferritinemia in Pulmonary Tuberculosis

High ferritin levels have been found to be associated with non infectious as well as infectious causes including tuberculosis. This is one case report of 41 year old male who presented with cough with expectoration. The patient had Multi drug resistant tuberculosis (MDRTB) and type 2 diabetes mellitus. The laboratory findings showed Iron 280 μg/dl, Total iron binding capacity (TIBC) 61 μg/dl, and ferritin 92,945 ng/ml which indicates that iron is an essential nutrient for the survival of the pathogen Mycobacterium tuberculosis.     

Assessment of Oxidative Stress and Inflammatory Process in Patients of Multiple Myeloma

Multiple myeloma is a disseminated malignancy of monoclonal plasma cells that accounts for 15 % of all hematological cancers. The present study was conducted to evaluate the role of inflammation and oxidant-antioxidant dynamics in the etiology of this disease. The study population comprised of 20 cases of multiple myeloma and 20 healthy controls. The parameters evaluated were serum malondialdehyde (MDA), superoxide dismutase (SOD) and ferritin levels. The serum MDA levels were 1.9 ± 0.96 nmol/ml in cases as compared to 0.98 ± 0.55 nmol/ml in the controls. Similarly, a statistically significant difference was noted in the SOD and ferritin levels between the cases and controls (93.2 ± 23.8 vs. 210.1 ± 190.5 U/ml and 285.8 ± 216.4 vs. 131.8 ± 30.1 ng/ml respectively). Our study highlights the imbalance in the oxidant-anti oxidant mechanism and the role of smoldering inflammation in the etiology of multiple myeloma.     

Studies of biochemical parameters in breast cancer with and without metastasis

The study includes 102 confirmed cases of carcinoma breast with and without metastasis and 25 healthy non-pregnant females. They were evaluated for blood levels of Ferritin, GSH, LDH, ALP, GGT and Hb before and 21 days after mastectomy. A significant increase (p<0.001) was observed in ferritin, LDH and GSH levels in cancer patients without metastasis in comparison to normal control subjects. Patients with metastasis had further elevated (p<0.001) levels of Ferritin, ALP and GGT as compared to non-metastatic patients. Mastectomy in both the cases i.e. with and without metastasis resulted in non-significant decrease in all the biochemical parameters suggesting that longer follow up could confirm post surgery decrease in the biochemical parameters. The results of the study suggest cost effective, usefulness of Ferritin, ALP, GGT and GSH/Hb ratio in differentiating breast cancer patients with and without metastasis which can be assayed in smaller laboratories.