铁调素与肾性贫血

正铁调素是一种由肝细胞产生和分泌的小分子肽,富含半胱氨酸,通过减少小肠对铁的吸收,以及减少网状内皮系统对铁的释放,负性调节铁代谢平衡,在铁代谢中起到关键调控作用。研究表明,在慢性肾脏病(CKD)非透析及透析患者中,铁调素前体、铁调素和铁调素代谢物均升高。由于血清高铁调素水平在CKD贫血的发生发展中具有重要作用,因此,铁调素未来可能作为一种潜在的肾性贫血诊断标志物     

铁调素与骨形态发生蛋白相互关系的研究进展

临床和实验研究均表明铁过载能引起骨质疏松,铁调素(hepcidin)是近年发现的调节体内铁代谢的关键因子,骨形态发生蛋白(bone morphegenetic proteins,BMPs)能上调铁调素的表达,提示BMPs在骨质疏松的恢复中起重要作用。本文对BMPs和铁调素关系的研究进展进行综述,以期为研究铁过载引起的骨质疏松及其治疗提供基础。     

铁调素调节与慢性丙型肝炎

铁调素（hepcidin）已经成为人们公认的铁的负性调节激素,调控十二指肠铁吸收和巨噬细胞铁释放的水平,在机体铁储存和铁循环中发挥着重要作用。实验和临床研究表明,慢性丙型肝炎（CHC）患者中经常出现轻度至中度铁超负荷,铁过载是促进肝损伤进展的一个危险因子,也是促进肝纤维化、肝硬化和肝细胞癌的危险因素。现就铁调素功能、铁调素的调节机制、在慢性丙型肝炎中铁调素表达的抑制等方面论述铁调素调节与慢性丙型肝炎的关系。     

老年慢性肾脏病患者铁调素与骨形态发生蛋白-2关系

目的老年慢性肾脏病(CKD)患者铁调素(hepcidin)与骨代谢指标骨形态发生蛋白-2(BMP-2)关系探讨。方法随机选择在本科门诊随访的30例非透析CKD 1~3A期患者,30例非透析CKD 4~5期患者及健康体检者30例作为对照。检测参试者血红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(Hct)、血清铁调素、血钙(Ca)、血磷(P)、全段甲状旁腺激素(i PTH)、超敏C反应蛋白(hs-CRP)、血清铁蛋白(SF)、BMP-2水平,并比较组间差异。采用多元回归分析铁调素的影响因素。结果 CKD患者血清铁调素水平显著高于健康对照组(P0.01)。与CKD 1~3A期相比,CKD患者CKD 4~5期血清铁调素水平升高(P0.05)。Pearson相关分析显示CKD患者血清铁调素水平与估算肾小球滤过率(e GFR)呈负相关(r=-0.484,P0.05),血清铁调素水平与尿素氮(BUN)、血肌酐(Scr)、Ca、P、BMP-2呈正相关(r=0.45、0.377、0.582、0.514、0.947,P均0.05)。多元逐步回归分析显示,CKD患者血清Scr、SF、BMP-2与铁调素水平密切相关。结论铁调素与e GFR相关,随e GFR下降,CKD进展、BUN、Scr水平上升,铁调素水平逐渐上升。铁调素与BMP-2水平密切相关,铁调素可能通过调节BMP-2,参与CKD患者骨代谢调节。     

初发2型糖尿病患者铁代谢指标的变化及分析

 本研究检测了新诊断2型糖尿病患者血清铁蛋白（ferritin,SF）、铁调素（hepcidin）及可溶性转铁蛋白受体（sTfR）水平,旨在探讨2型糖尿病患者铁代谢的变化。     

转铁蛋白受体-2在铁稳态中的作用研究进展

铁是人体内非常重要的元素，不仅参与细胞构成，还广泛参与重要的生命代谢过程。体内铁稳态的维持对正常机体生长发育和健康发挥着重要作用。铁调素(hepcidin)是维持铁稳态的重要分子，hepcidin水平受许多因素的调节，近年来有研究发现转铁蛋白受体-2(transferrin receptor 2,TFR2)参与了多条hepcidin调节通路，进而调节全身铁代谢。本文就TFR2在铁稳态中的作用相关研究进展作一综述。     

以斑马鱼为模式动物研究铁调素在骨质疏松中的作用

骨质疏松是一种骨代谢异常,成骨、破骨功能失衡所致的全身性疾病,骨质疏松常见于绝经后女性,而绝经后10年的女性往往会出现铁蓄积,所以将铁蓄积与骨质疏松症联系起来的研究越来越多。铁调素(hepcidin)作为调节机体铁稳态的一类抗菌多肽被人们重视,铁调素的相关研究有了越来越多的研究报道:围绕铁蓄积与骨代谢,铁调素与铁蓄积,基因突变与铁调素等。斑马鱼作为骨质疏松模式动物的优势,铁调素基因在斑马鱼中的研究进展颇多。目前铁调素在传统模式动物的研究已经开展,但对于斑马鱼中的铁调素研究较少,本综述旨在拓展了斑马鱼作为模式动物研究铁调素的认识     

铁调素及相关干预药物的研究进展

铁转运障碍是慢性肾脏病(CKD)患者难治性贫血的常见原因。铁调素是机体维持铁稳态的关键激素,可负向调节铁代谢,该过程由多种信号通路调节,包括骨形志发生蛋白/Smad信号通路、Janus激酶/信号转导与转录激活子3通路、炎症、促红细胞生成、缺氧等。铁调素已成为临床治疗铁代谢失衡的主要靶点。近年来,国内外研发了多种铁调素调节相关药物,其中以罗沙司他为代表的缺氧诱导因子脯氨酸羟化酶抑制剂类药物被认为可有效减少铁调素表达,提高血清铁水平,进而促进红细胞生成,治疗CKD患者的贫血。     

2型糖尿病患者铁代谢指标的变化及意义

目的观察2型糖尿病患者铁代谢指标的变化并探讨其意义。方法选取130例2型糖尿病患者（观察组）和130例健康体检者（对照组）,比较两组全血Fe、血清铁（SI）、血清铁蛋白（Fer）、血液红细胞铁（FBC）及铁调素（Hep）含量。结果观察组全血Fe、SI、Fer、FBC、Hep水平均高于对照组（P均〈0.05）。结论 2型糖尿病患者的铁代谢相关指标均升高,其可作为糖尿病微血管并发症的预测因子。     

慢性乙型、丙型肝炎患者肝脏铁调素表达的下调

目的:研究慢性乙型、丙型肝炎患者体内炎性反应与铁代谢调节的相互作用机制.方法:纳入慢性乙型、丙型肝炎患者各45例、健康成人90例(各对照45例),分为慢性乙型肝炎患者组(HBV组)、慢性丙型肝炎患者组(HCV组)及对照组,ELISA法检测血清铁调素(hepcidin)、白介素-6(interleukin6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α),全自动生化仪检测丙氨酸转氨酶(alanine transaminase,ALT)、天冬氨酸转氨酶(aspartate aminotransferases,AST)、血清铁(Fe).选取慢性丙型肝炎患者肝脏及十二指肠标本15例(HCV组)、慢性乙型肝炎患者肝脏及十二指肠标本12例(HBV组)和对照组12例,免疫组织化学检测肝脏铁调素(hepcidin)及十二指肠膜铁转运蛋白(ferroportin)表达情况,肝脏铁蓝染色检测肝脏铁蓄积情况.结果:与对照组比较,HBV、HCV组血清铁调素水平及肝脏铁调素表达均降低(P0.05);十二指肠膜铁转运蛋白表达均升高(P0.05),HCV组升高更明显(P0.05),肝脏铁蓝染色的阳性表达均升高(P0.05),HCV组升高更明显(P0.05).HBV及HCV组十二指肠膜铁转运蛋白表达与肝脏铁调素表达均呈负相关(r=-0.638,P0.05;r=-0.538,P0.05),与血清铁调素均呈负相关(r=-0.407,P0.05;r=-0.519,P0.05),与血清Fe均呈正相关(r=0.611,P0.05;r=0.637,P0.05).在HBV组,血清铁调素与IL-6及TNF-α均呈负相关(r=-0.510,P0.05;r=-0.450,P0.05);在HCV组,血清铁调素与IL-6呈负相关(r=-0.620,P0.05),与TNF-α呈正相关(r=0.243,P0.05).结论:慢性乙型、丙型肝炎患者体内铁调素水平下调并通过上调膜铁转运蛋白的表达导致体内血清铁水平升高及肝铁蓄积,HCV组肝铁蓄积更明显.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.