Authors:Khadiga G. Adham, Manal H. Farhood, Maha H. Daghestani, Nadia A. Aleisa, Ahlam A. Alkhalifa, Maha H. El Amin, Promy Virk, Mai A. Al-Obeid, and Eman M. H. Al-Humaidhi
One of the common causes of iron overload is excessive iron intake in cases of iron-poor anemia, where iron saccharate complex (ISC) is routinely used to optimize erythropoiesis. However, non-standardized ISC administration could entail the risk of iron overload. To induce iron overload, Wistar rats were intraperitoneally injected with subacute (0.2 mg kg−1) and subchronic (0.1 mg kg−1) overdoses of ISC for 2 and 4 weeks, respectively. Iron status was displayed by an increase in transferrin saturation (up to 332%) and serum and liver iron burden (up to 19.3 μmol L−1 and 13.2 μmol g−1 wet tissue, respectively) together with a drop in total and unsaturated iron binding capacities “TIBC, UIBC” as surrogate markers of transferrin activity. Iron-induced leukocytosis (up to 140%), along with the decline in serum transferrin markers (up to 43%), respectively, mark positive and negative acute phase reactions. Chemical stress was demonstrated by a significant rise (p > 0.05) in indices of the hemogram (erythrocytes, hemoglobin, hematocrit, leukocytes) and stress metabolites [corticosterone (CORT) and lactate]. Yet, potential causes of the unexpected decline in serum activities of ALT, AST and LDH (p > 0.05) might include decreased hepatocellular enzyme production and/or inhibition or reduction of the enzyme activities. The current findings highlight the toxic role of elevated serum and liver iron in initiating erythropoiesis and acute phase reactions, modifying iron status and animal organ function, changing energy metabolism and bringing about accelerated glycolysis and impaired lactate clearance supposedly by decreasing anaerobic threshold and causing premature entering to the anaerobic system.
The prevalence of hepatitis C virus infection among patients on hemodialysis is about ten times higher than in the normal population. The infection can induce chronic glomerulonephritis, as an extrahepatic manifestation, which can lead to end-stage renal disease. However, in the majority of patients hepatitis C virus is acquired as a nosocomial infection during hemodialysis. Most of the infected patients have usually normal liver enzymes and need regular screening for hepatitis C antibody to detect the infection. Despite the normal liver enzymes, the liver disease may progress to cirrhosis. Some of the patients are on the renal transplantation waiting list. The immunosuppressive treatment after renal transplantation results in a significantly increased viral replication which might induce further progression of the liver disease. Interferon treatment given after transplantation can induce rejection and graft failure. Therefore the antiviral treatment should be administered during or before the hemodialysis period. Only limited data are available about the treatment of patients with impaired renal function. Alfa-interferon was used mostly in these patients. Due to its impaired renal clearance and higher serum concentration interferon seems to be more effective, but less tolerable in patients with end-stage renal disease than in other groups of patients. Ribavirin is also excreted exclusively by the kidney with anemia being even more pronounced in these patients, and as such is contraindicated in patients on hemodialysis. The pharmacokinetics of the pegylated interferon alfa-2a is very advantageous for patients with end-stage renal disease. The safety and efficacy of peginterferon alfa-2a is now being confirmed in many publications.
Authors:Fumina Sasaoka, Jin Suzuki, Toh-Ichi Hirata, Toshihiro Ichijo, Kazuhisa Furuhama, Ryô Harasawa, and Hiroshi Satoh
. , Griot , C. , Stark , K. D. C. , Willi , B. , Schmidt , J. , Kocan , K. M. and Lutz , H. ( 2004 ): Concurrent infections with vector-borne pathogens associated with fetal hemolytic anemia in a cattle herd in Switzerland . J. Clin. Microbiol
Sulkowski, M. S., Poordad, F., Manns, M. P., et al.: Anemia during treatment with peginterferon alfa-2b/ribavirin with or without boceprevir is associated with higher SVR rates: analysis of previously untreated and previous treatment – failure patients. J
Authors:B. Panwar, I. Kádár, B. Bíró, K. Rajkai-Végh, P. Ragályi, M. Rékási, and L. Márton
Phytoremediation is an approach designed to extract excessive heavy metals from contaminated soils through plant uptake. Cadmium (Cd) is among the elements most toxic to living organisms. Health hazards associated with the lethal intake of Cd include renal (kidney) damage, anaemia, hypertension and liver damage. A greenhouse experiment was carried out with Indian mustard (Brassica juncea) grown on artificially spiked soil (100 μg Cd g−1) with EDTA (2 mmol kg−1 in 5 split doses), FYM, vermicompost (VC) and microbial inoculants (MI) such as Azotobacter sp. and Pseudomonas sp. The growth of Brassica juncea L. was better in soil amended with FYM or VC as compared to unamended Cd-polluted soil. Growth was slightly suppressed in EDTA-treated soil, whereas it was better after treatment with MI. The application of FYM and VC increased the dry matter yield of Indian mustard either alone or in combination with microbial inoculants, while that of EDTA caused a significant decrease in the biomass of Indian mustard. The application of microbial inoculants increased the dry matter yield of both the roots and shoots, but not significantly, because MI shows greater sensitivity towards cadmium. The maximum cadmium concentration was observed in the EDTA +MI treatment, but Cd uptake was maximum in the VC + MI treatment. The Cd concentration in the shoots increased by 120% in CdEDTA over the Cd100 treatment, followed by CdVC (65%) and CdFYM (42%) in the absence of microbial inoculants. The corresponding values in the presence of MI were 107, 51 and 37%, respectively. A similar trend was also observed in the roots in the order CdEDTA+M > CdVC+M > CdFYM+M>Cd100+M.MI caused an increase in Cd content of 5.5% in the roots and 4.1% in the shoots in the CdEDTA+M treatment compared with the CdEDTA treatment. FYM, VC and EDTA also increased Cd uptake significantly both in the shoots and roots with and without microbial inoculants.The results indicated that Vermicompost in combination with microbial inoculants is the best treatment for the phytoremediation of Cd-contaminated soil by Indian mustard, as revealed by the Cd uptake values in the shoots: CdVC+M (2265.7 μg/pot) followed by CdEDTA+M (2251.2 μg/pot), CdFYM+M (1485.7 μg/pot) and Cd100+M (993.1 μg/pot).
The main indication for liver transplantation is the final stage of hepatic cirrhosis developed due to hepatitis C virus (HCV) infection. The recurrence of HCV infection after transplantation is a common situation. Recurrent hepatitis C is a progressive disease; in 20% of patients it produces liver cirrhosis without treatment beside immunosuppression within 5 years. Treatment of recurrent HCV infection is the most important factor of survival in patients with transplantation. Based on literary data and their observations, the authors review the factors influencing the progression of recurrent HCV infection. They discuss in details the effect of immunosuppressive therapy, the importance of selecting appropriate immunosuppressive drugs. They review the key points in the diagnosis of recurrent hepatitis C; underline the decisive role of liver biopsy carried out according to protocol in the diagnosis, as well as the hard consultation between specialists of pathology, hepatology and surgery. They demonstrate their observations with the treatment of patients on the waiting list, the results of early pre-emptive treatment of recurrent chronic hepatitis, furthermore treatment modalities and results in patients with histologically proven chronic hepatitis C. The drug of choice for chronic hepatitis C after transplantation is combined therapy with pegylated interferon and ribavirin. This therapy is able to assure sustained virological negativity in 20–50% of patients. In virus-free patients the inflammatory activity in the liver significantly decreases, and the histologic activity index improves. There are data showing a fibrosis-inhibiting effect of the treatment, however, multicentric studies are required for their confirmation. No advantage of early antiviral treatment without histologic alteration has been confirmed by most of the trials. In this group of patients common side effects of the treatment include anaemia and neutropenia, and therefore administration of erythropoietin and granulocyte stimulating factor is recommended. Further research and clinical studies are required in order to establish optimal treatment of patients with recurrent hepatitis C, to determine the dosage of pegylated interferon and ribavirin, to decrease duration of therapy, to reduce side effects and finally to achieve the healing phase in a greater percentage of patients.