Dr: Mohamed Maher
Research Assistant at National cancer
Institute (NCI)
Founder of Plasma Labs
Founder of plasma company
Phone : 01063729893
Mail : [email protected]
To diagnose type of microcytic hypochromic
anemia ,Iron profile is recommended .
Iron
Ferritin
TibC(total iron binding capacity)
Transferrin saturation
Iron profile
You need iron to make healthy red blood cells. Red blood cells carry oxygen from your lungs to
the rest of your body. Iron is also important for healthy muscles, bone marrow, and organs,
including brain development in children.
iron binds to a protein called transferrin, which transports it to different parts of the body. Extra iron is stored in
ferritin,
Ferroportin is your body’s iron exporter. Its job is to release iron from storage (from macrophages, hepatocytes
and enterocytes) and move iron among your body’s cells. Ferroportin transports iron from your small intestine to
your bloodstream so your body can use it.
Ferroportin
Hepcidin gets made in your liver and secreted into your bloodstream.
Hepcidin is a hormone thatregulates how your body uses iron.
hepcidindecreases the level of iron by reducing dietary absorption and inhibiting iron release from cellular storage.
Hepcidin production increases when iron levels rise
Hepcidin is sometimes called the “master iron regulator” because it controls how much iron is available for your cells to
perform essential processes, like making hemoglobin and red blood cells. Too little iron can lead to conditions like iron-
deficiency anemia, where your body doesn’t make enough red blood cells. Too much iron can be toxic (poisonous) and
even life-threatening.
Hepcidin is sometimes called the “master iron regulator”
Hepcidin acts on a protein called
ferroportin.
Hepcidin binds to ferroportin, causing it to
break down. When this happens, the iron that
ferroportinwould’ve moved to your
bloodstream remains in storage.
Think of it this way:
More hepcidinmakes it harder for ferroportin
to transport iron to your bloodstream,
preventing iron absorption.
Less hepcidinmakes it easier for ferroportinto
transport iron to your bloodstream, enabling
iron absorption.
How does hepcidin regulate iron absorption?
What factors influence how much hepcidinyou have?
Your hepcidinlevels depend on the signals your body sends. Various factors
prompt your body to make more or less hepcidin.
Factors that control hepcidinlevels in your body include:
•The total amount of iron in your body:Low iron levels signal your body to
make less hepcidin, while high iron signals your body to produce more hepcidin.
•The production of red blood cells: Hepcidin levels decrease when your body
needs more hemoglobin for red blood cell production. The decrease allows
ferroportinto transport iron so new cells get made.
•Low oxygen levels (hypoxia):Hypoxia occurs when you don’t have enough
oxygen in your tissues. Low oxygen signals your body to decrease hepcidin,
freeing up ferroportinto release the iron needed to make hemoglobin, which
helps transport oxygen via red blood cells.
•Inflammation in response to an injury or an infection:Hepcidin levels
increase to prevent iron from being released into your body. Many harmful germs,
like bacteria, use iron to thrive. The increase in hepcidinand the decrease in iron
prevent these germs from accessing it.
•Iron overload:High levels of iron are referred to as iron overload or hemochromatosis. Your body does not
have a natural way to get rid of extra iron and it will deposit it in body tissues, like the liver, heart, and
pancreas. Iron overload can cause serious damage to your organs.disorder in which iron salts are deposited
in the tissues, leading to liver damage, diabetes mellitus, and
Iron overload or hemochromatosis
bronze discoloration of the skin.
•Iron deficiencyanemia, having too few red blood cells because you lack iron
•Iron deficiency
Ferritin is a protein that storesironinside your
cells
I.Ferritin is composed of 2 different subunits, H
and L. Different studies have suggested that H
subunit expression is driven by inflammatory
stimuli and H-ferritin may work as an
immunomodulatory molecule, displaying both
pro-inflammatory and immunosuppressive
functions
II.Ferritin is an evolutionarily conserved globular
protein, composed of 24 polypeptide chains.
III.It forms a spherical shape that is approximately
8 nm in diameter, allowing it to store
approximately 4,500 Fe atoms
IV.which is usually concentrated in the liver and
the cells of the immune system and hair
follicles
Ferritin
Iron cannot exist on its own in the body. Instead,
When the body uses stored iron, a metabolic process separates iron from the ferritin inside the cell. In this
process, a small amount of ferritin leaves the cell and moves into the blood
Diagnosis
Help diagnose or rule out conditions related to iron levels, including:
I.Hemochromatosis, having too much iron in your body (also called iron
overload)
II.Iron deficiency anemia:If your body’s iron levels are consistently low,
iron deficiency can progress to anemia. Low iron levels in the blood
reduce production of red blood cells, which affects the body’s ability to
deliver enough oxygen to muscles and organs.
III.Liver disease:A large amount of our iron is stored in ferritin proteins in
the liver. When the liver is damaged or diseased, iron and ferritin can leak
from the liver into the blood. Ferritin testing can help diagnose liver
conditions such as alcohol abuse, cirrhosis, and Hepatitis B and C
infection.
IV.Patients with chronic conditions like cancer, liver disease, or kidney
disease may also have regular ferritin testing as part of regular blood
work to check for signs of iron overload or iron deficiency that may
require treatment.
What is it used for?
The relation between ferritin and hair growth ?
•Many parts of the body contain
ferritin, including the spleen, liver,
blood, and hair follicles. When a
person has a low ferritin count,
they will also be low in iron
•1 -One explanation for why
reduced iron levels lead to hair
loss is that when the body is low in
iron, it takes the ferritin stored in
the hair follicles for use elsewhere
in the body. The reduced levels of
ferritin in the hair follicles could
weaken the hair itself and lead to
hair loss.
•Iron is an essential nutrient,
meaning that the body cannot
produce it and must obtain it
entirely through the diet. People
who do not eat enough iron-rich
foods may be at risk of having low
ferritin levels.
2-Iron plays a vital role in many essential bodily processes. Without iron, the body cannot create enoughred blood
cells.
Red blood cells transport oxygen around the body. When there are fewer red blood cells available, the body has difficulty
transporting oxygen to the various organs and tissues. This can cause a range of problems, includinganemiaandhair loss.
However, raising ferritin levels will not
increase hair growth in healthy
individualswho have normal iron and
ferritin levels.
It is also important to note that too much
iron can cause side effects, such as iron
poisoning and even organ and tissue
damage.
raising ferritin levels will increase hair growth ?
The relation between covid19 virus and ferritin
Studies on COVID-19 patients have
reported the levels of some
inflammatory markers such as
procalcitonin, C-reactive protein,
erythrocyte sedimentation rate and
serum amyloid A. However, little
attention has been paid to ferritin,
even though hyperferritinemiahas
been shown to be associated with
complications in other viral diseases
such as dengue fever[3]. In order to
determine if the circulating ferritin
concentration could be used to
predict COVID-19 progression,
However, we should ask what the source of the increased plasma ferritin concentration is and the
potential role of this protein during inflammation following COVID-19 disease development
Ferritin and CKD
Chronic kidney disease (CKD) is defined by sustained and impaired renal
function that may result from a loss of functional nephrons.
Kidneys are the main source of erythropoietin(EPO), a hormone that
regulates red blood cell production.
Hepcidin prevents iron egress from cells and increases intracellular
ferritin expression
. However, anemic CKD patients exhibit a contradictory elevation in
serum ferritin levels which confounds iron treatment strategies. This
may be attributed to inflammation and oxidative stress, both of which
occur in the majority of patients diagnosed with CKD. Inflammation
associated with CKD increases ferritin and hepcidinindependent of the
body’s iron composition. Hepcidin prevents iron egress from cells and
increases intracellular ferritin expression
FtHmay increase the antioxidant potential and thereby
promote survival of cancerous cells. In contrast, emerging
data demonstrate that FtHmay inhibit tumor growth by
interacting with survivin.
97
Survivinis a regulatory protein
that controls apoptosis, cell division and metastasis, and is
often overexpressed in cancer cells.
FtHand FtLduring tumorigenesis. Serum ferritin
measurement has also been used as a tumor marker in RCC
and exhibits a strong correlation with the stage of RCC and
the kidney tumor volume.
98,99
Using ferritin as a marker for
RCC may ensure an accurate diagnosis and enable
development of a successful treatment regimen.
Ferritin and Renal Cell Carcinoma
Total iron-binding capacity
•Atotal iron-binding capacity (TIBC) test
measures the blood's ability to attach
itself to iron and transport it around the
body. A transferrin test is similar.
•If you haveiron deficiency anaemia(a lack
of iron in your blood), your iron level will be
low but your TIBC will be high.
•If you have too much iron (for example, if
you have a condition
likehaemochromatosis), your iron level will
behigh but your TIBC will be low or
normal.