Hemochromatosis

铁蛋白(Ferritin)是一种广泛存在于细胞内的高分子蛋白质，而血清铁蛋白(Serum Fertin, SF)是体内含铁最丰富的一种蛋白质，主要存在于肝、脾、骨髓等网状内皮系统内，发挥着重要作用。 1、什么是铁蛋白 铁蛋白(Ferritin)是一种广泛存在于细胞内的高分子蛋白质，主要通过储存铁离子以调节细胞内的铁稳态。铁蛋白由 24 个亚基以高度对称性方式组成，这些亚基组装成一个外径12～13nm的空心球形结构。该结构内部有一个由铁和磷酸盐分子组成的核心，称为铁核，其中的氢氧化铁核中可积累多达4000个铁原子。 血清铁蛋白(Serum Fertin, SF)是体内含铁最丰富的一种蛋白质，是去铁蛋白和三价铁Fe3+形成的复合物。血清铁蛋白主要存在于肝、脾、骨髓等网状内皮系统内，为骨髓合成血红蛋白供铁，并按机体的需要向血清中释放。血清铁蛋白的主要功能是反映机体内的总体铁状态。它可以用于评估铁缺乏症、铁过载和炎症等疾病。 2、标准值 正常人群的铁蛋白参考范围： 男性，20‑60岁：30‑400 µg/L（ng/mL） 女性，17‑60岁：13‑150 µg/L（ng/mL） 孕妇人群的铁蛋白参考范围暂无统一标准，有文章建议以<20 ng/ml为诊断缺铁性贫血的指标。另外，不同地区人群血清蛋白参考区间往往不同，实验室应按照所在地区病人种群特征研究是否可以采用给定的参考值。 3、铁蛋白和肿瘤的关系 铁蛋白是一种与铁稳态密切相关的蛋白质，在肿瘤发生发展中发挥着重要作用。铁是多种酶和蛋白质的必需元素，包括细胞呼吸、DNA合成和细胞分裂所必需的酶。因此肿瘤细胞对铁的需求很高，以支持其快速增殖和代谢的需求。目前，铁蛋白已被研究作为多种癌症的潜在肿瘤标志物，如肝癌含有一种被称为癌胚异铁蛋白的酸性异铁蛋白，有助于肝癌的早期诊断，除此之外，铁蛋白在结直肠癌、乳腺癌、肺癌等癌症的诊断中也扮演着重要的角色。 血清铁蛋白水平与常见血液肿瘤也有着密切的联系。 血清铁蛋白与白血病：一项研究分析了543例进行同种异体造血干细胞移植的淋巴瘤、骨髓增生异常综合症、急性/慢性髓系白血病的患者的研究发现，97%急性髓系白血病患者出现血清铁蛋白升高。此外，有研究发现当血清铁蛋白截断值为1200 ng/L 时，高血清铁蛋白白血病患者与较差的无病生存率和总生存期以及较高的累积复发率显著相关。 血清铁蛋白与淋巴瘤：高血清铁蛋白水平是非霍奇金淋巴瘤患者5年无瘤生存的独立预后因素，血清铁蛋白水平高的患者有更低的总生存时间和无进展生存时间。血清铁蛋白≥500 ng/mL 可能是预测非霍奇金淋巴瘤预后不良的重要指标。在另一项研究中，血清铁蛋白水平≥ 500 ng/mL 是弥漫大 B 细胞淋巴瘤生存时间和无进展生存时间的独立预后不良因素，可有助于预测患者的存活率。 血清铁蛋白与嗜血细胞综合征：2004年国际组织细胞协会修订标准（HLH-2004）嗜血细胞综合征中诊断以血清铁蛋白500 μg/L作为临界值来源于一项纳入34例的队列研究，其灵敏度为84%，特异度不详。但国内外学者对HLH-2004诊断标准中的血清铁蛋白以500 μg/L作为临界值存在争议。 血清铁蛋白与造血干细胞移植：一项对 240 例接受异基因造血干细胞移植的患者的研究测量了其 1 年后的铁蛋白水平，结果显示铁蛋白水平高于1000 ng /mL 与5年较差生存相关 ( 85% vs 64% ，P < 0.001，HR = 3.5 )。 4、血清铁蛋白的促癌作用机制 毒性作用：特发性血色素沉着症的患者是一种由于铁代谢异常导致以过剩的铁堆积为特征的一种遗传性疾病，由于铁超载的存在，其发生各系统肿瘤的风险明显增加。在正常人群中也发现当机体摄入过多的膳食铁时，机体癌症的发生率也有所增加，相反经静脉放血治疗和经常献血使体内铁储存减少的人群中多个系统癌症的发生风险有所下降。 耐药作用：铁蛋白对铁诱导的 DNA 损伤具有保护作用。例如，阿糖胞苷耐药的急性髓系白血病患者表达极其丰富的铁蛋白基因；铁蛋白重链在淋巴瘤的发生过程中发挥着一定的作用，并且参与化疗耐药的产生。 抗氧化损伤：细胞内未结合的铁离子能够通过芬顿反应产生活性氧，导致脂质过氧化、DNA损伤等，从而诱发基因突变和表观遗传改变，促进肿瘤的发生和转移。 免疫抑制：一些证据表明，细胞外铁A蛋白通过调节铁利用率，对淋巴细胞和骨髓细胞发挥免疫抑制作用。大多数肿瘤患者中重链铁蛋白的比例增加，并且伴随着循环中CD25、CD4调节T细胞的升高。 促进血管生成：高分子量激肽原（HK）是一种在内源性凝血途径中发挥作用的糖蛋白，HK的分解产物（HKa）具有抗血管生成作用。活体研究中发现，铁蛋白能够抑制肿瘤微环境中HKa的抗血管生成作用，保护肿瘤血管内皮细胞免于HKa引起的凋亡。 5、其他引起铁蛋白水平变化的疾病 虽然铁蛋白近年来作为肿瘤筛查标志物出现在体检套餐中，但其实引起血清铁蛋白水平变化的因素非常多，并且在不同的疾病中血清铁蛋白含量改变有着不同的临床意义。 血清铁蛋白降低常见于： （1）缺铁性贫血：血清铁蛋白水平降低对缺铁性贫血的诊断具有很高特异性。血清铁蛋白水平 < 14 μg/L 时提示铁贮备耗竭，可诊断为缺铁性贫血，有研究表明血清铁蛋白水平检测对于缺铁性贫血的诊断灵敏度为59%，特异度达 99%。 （2）神经系统疾病：铁参与多种神经代谢过程，影响中枢神经系统，导致神经认知和行为发育改变。有研究认为低铁蛋白血症可能是多动症的病因之一，血清铁蛋白水平与患儿的冲动控制和注意力呈正相关。而对阿尔茨海默病患者铁蛋白水平的测定则得出患者脑脊液中的铁蛋白水平与其认知能力呈负相关的结论。 （3）长期腹泻和营养不良。 除肿瘤外，血清铁蛋白升高还常见于： （1）急性感染和炎症：可促进去铁铁蛋白（天然的铁储存蛋白）合成，使铁蛋白增高。 （2）消化系统：多见于肝脏疾病如急慢性肝炎、肝硬化、肝坏死、脂肪肝等。患者干细胞功能下降，导致铁蛋白的摄取及清除受到影响，使铁蛋白升高。 （3）心脑血管病：急性心肌梗死、动脉粥样硬化、原发性高血压、脑梗死、脑出血等。流行病学调查显示，铁蛋白水平升高增加了冠状动脉疾病和心肌梗死的危险。 （4）呼吸系统：肺结核、肺炎等。 （5）内分泌代谢性疾病：2型糖尿病、成人still’s病、代谢综合征等。 （6）肾脏疾病：慢性肾病、尿路感染等。糖尿病肾病是糖尿病最常见的微血管并发症之一，近期部分研究发现，体内铁贮存量与糖尿病关系密切，铁蛋白升高与糖尿病肾病风险增加相关。 6、铁蛋白检查注意事项 由此可见，血清铁蛋白升高的原因多种多样，是一种非特异性的标志物，所以遇到铁蛋白水平升高不需要慌张，需进行进一步检查，结合临床具体分析。 在检测血清铁蛋白水平时，有以下几点注意事项： 1.需空腹12小时以上再抽血化验。 2.检查前禁止铁剂治疗和含铁高的食物，如动物肝脏等，同时禁食能和铁络合的物质，如茶等。 3.排除生理现象，如女性月经期、妊娠期和婴儿生长期，这几个体内铁的需要量增加的时期，可造成血清铁的检测降低。 参考文献： [1]Armand P, Kim H T, Cutler C S, et al. Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation [J]. Blood, 2007, 109(10): 4586-8. [2]Yoh KA, Lee HS, Park LC, et al. The prognostic significance of elevated levels of serum ferritin before chemotherapy in patients with non-Hodgkin lymphoma [J]. Cl Lymph Myelom Leuk, 2014, 14(1): 43-49. [3]王云鲭,郑雅龄,王磊,等.移植后铁蛋白升高预测异基因造血干细胞移植血小板植入延迟[J].广东医学,2023,44(02):173-177. [4]罗欣,吴耿航,李碧婷,等.血清铁蛋白在儿童嗜血细胞综合征诊断中应用价值[J].中华实用诊断与治疗杂志,2021,35(04):380-382.DOI:10.13507/j.issn.1674-3474.2021.04.014 . 公众号内回复“ADC”或扫描下方图片中的二维码免费下载《抗体偶联药物：从基础到临床》的PDF格式电子书！ 公众号已建立“小药说药专业交流群”微信行业交流群以及读者交流群，扫描下方小编二维码加入，入行业群请主动告知姓名、工作单位和职务。

ELKO, Nev., March 7, 2025 /PRNewswire/ -- Community Health Development Partners (CHDP), in collaboration with Barrick-operated Nevada Gold Mines (NGM), is pleased to announce the grand opening of the CHDP Infusion Center in Elko, Nevada. This state-of-the-art facility is now open to serve patients who require cancer treatment, as well as non-cancer related infusions and injections. The CHDP Infusion Center, a partnership with NGM, is designed to provide comprehensive care for a wide range of health conditions, including: Cancer Treatment and Care: From early detection to chemotherapy and care planning, patients will have access to expert oncologist support through a partnership with Intermountain Healthcare, ensuring the highest level of medically advanced care. Autoimmune Disorder Treatments: The center offers infusions and injections for a variety of autoimmune conditions, including rheumatoid arthritis, multiple sclerosis, Crohn's disease and more. Treatment for Other Health Conditions: Patients with anemia, dehydration, polycythemia, hemochromatosis and vitamin or mineral deficiencies may also receive care at the Infusion Center. The center features nine comfortable infusion chairs, a telepresence suite with individual iPads at each chair, all within a wellness-focused environment. Patients have access to a snack center while receiving the latest in infusion therapy with personalized care. Additionally, the CHDP Infusion Center provides a range of supportive services, including: Patient Navigation Services Financial Navigation Oncology Pharmacy 24-hour Advice Nurse Cancer Survivorship Support PICC Line and Access Port Placement Hematology The opening of the CHDP Infusion Center marks a significant milestone in expanding access to essential healthcare services in Elko and the surrounding region. This achievement is a testament to the strong partnership between NGM and CHDP, highlighting their shared commitment to improving the health and well-being of the community. "We are proud assist in bringing state-of-the-art treatment options closer to home, ensuring that individuals and families can receive the compassionate, high-quality care they deserve," said Bob Connolly, NGM Total Rewards Manager. For more information or to schedule an appointment, please contact the CHDP Infusion Center. SOURCE CHDP WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

TORONTO, Jan. 22, 2025 (GLOBE NEWSWIRE) -- Only nine per cent of Canadians prioritize their liver when thinking about their health — well behind heart, mental, digestive, lung and even skin health. That finding comes from a new survey released today by Liver Canada, formerly known as the Canadian Liver Foundation. “Despite one in four Canadians being affected by liver disease, we now know that very few are truly prioritizing their liver health,” says Jennifer Nebesky, president and CEO of Liver Canada. “This goes to show why liver health awareness is more important now than ever.” Conducted by Abacus Data, the survey of 2,500 Canadians found that while liver health is the least considered area when assessing one’s health, Canadians with a personal connection to liver disease are twice as likely to consider their liver health a priority. The survey also found that long-standing myths about liver disease persist, with 84 per cent of Canadians blaming alcohol as the top culprit for poor liver health. “When we only focus on alcohol consumption, this leads many Canadians to pay less attention to other factors that have just as much, if not more, of an impact on your liver health,” says Nebesky. Once considered rare, liver cancer has also become one of the fastest-growing cancers in Canada and is the fifth-leading cause of cancer-related deaths among men. Roughly 10 million Canadians are impacted by metabolic dysfunction-associated steatotic liver disease (MASLD), more commonly known as fatty liver disease. This number is expected to rise an additional 20 per cent by 2030. With cases of both liver disease and liver cancer increasing, Liver Canada is determined to raise awareness, drive prevention and support Canadians through education, advocacy and research. “We want Canadians to understand how crucial liver health is to their overall well-being,” says Nebesky. “It’s one of the reasons we’ve rebranded as Liver Canada — it’s a way of reaffirming our commitment to addressing the growing liver health crisis in our country.” Liver Canada’s action planLiver Canada empowers all Canadians to take proactive steps to protect and improve their liver health through advocacy, education, support and research: Awareness: Through life-saving research, vital education, community support and advocacy campaigns, Liver Canada is committed to making a meaningful difference in the lives of all Canadians.Education in schools: Liver Canada has designed a new school-based program to help the next generation understand the importance of liver health, with workshops in select schools throughout the 2024-2025 school year.Prevention: Preventing liver disease starts with nutrition, lifestyle changes and early screenings. Liver Canada is here to help with an information hub that supports Canadians on their path to better liver health, free liver-friendly recipes and a toll-free helpline.Research: Liver Canada has invested more than $38 million in liver research and has played a vital role in some of Canada's most noteworthy liver-related scientific breakthroughs, including discovering the genes responsible for Wilson's disease and hemochromatosis and new treatments for hepatitis C. The organization continues to fund innovative studies spanning all forms of liver disease. Learn more about Liver Canada and all its initiatives for 2025 at liver.ca Media contact Jennifer Nebesky, president and CEO of Liver Canada, is available for interviews. Liver Canada can also connect media with its medical partners across the country. To arrange an interview, please contact:Holly NyenkampSenior Director of Marketing and Communications at Liver Canadahnyenkamp@liver.ca