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铁过载在各地情况不同:巴西铁代谢基因突变的特点及针对该人群铁过载调查与管理的建议。

Iron overload is not the same everywhere: Particularities of iron-metabolism gene mutations in Brazil and a proposal for the investigation and management of iron overload in this population.

作者信息

de Melo Campos Paula, Toreli Ana Carolina, de Albuquerque Dulcinéia Martins, Costa Fernando Ferreira

机构信息

Hemocentro, Universidade Estadual de Campinas - Unicamp, Campinas, São Paulo, Brazil.

Hemocentro, Universidade Estadual de Campinas - Unicamp, Campinas, São Paulo, Brazil.

出版信息

Hematol Transfus Cell Ther. 2025 Apr-Jun;47(2):103846. doi: 10.1016/j.htct.2025.103846. Epub 2025 May 15.


DOI:10.1016/j.htct.2025.103846
PMID:40378601
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12131004/
Abstract

There is no physiological mechanism for the excretion of iron in humans, and excess iron may lead to severe tissue damage if not adequately treated. Iron overload can be caused by genetic factors (hemochromatosis) or acquired conditions (e.g., ineffective erythropoiesis, transfusions, iatrogenic iron treatment, viral hepatitis, alcohol intake, severe liver disease, metabolic dysfunction), and, in many cases, by a conjunction of these factors. Historically, guidelines for the genetic investigation of patients with iron overload have been based on data obtained from Caucasian individuals in Europe and North America. However, due to the genetic heterogeneity of iron overload gene mutations worldwide, these recommendations might not be applicable to other ethnic groups. This study analyzed previously published genetic data obtained from Brazilian patients with iron overload and found a relevant but small prevalence of HFE C282Y/C282Y patients when compared to European populations, while mutations of the TFR2, SCL40A1, HJV, HAMP, BMP6 and SLC11A1 genes seem to be important. This study proposes an adapted algorithm for the investigation and management of iron overload in Brazil.

摘要

人体不存在排泄铁的生理机制,如果得不到充分治疗,过量的铁可能会导致严重的组织损伤。铁过载可由遗传因素(血色素沉着症)或后天因素(如无效红细胞生成、输血、医源性铁治疗、病毒性肝炎、酒精摄入、严重肝病、代谢功能障碍)引起,在许多情况下,是由这些因素共同作用导致的。从历史上看,铁过载患者基因调查的指导方针是基于从欧洲和北美的白种人那里获得的数据。然而,由于全球铁过载基因突变的遗传异质性,这些建议可能不适用于其他种族群体。本研究分析了先前从巴西铁过载患者那里获得的基因数据,发现与欧洲人群相比,HFE C282Y/C282Y患者的患病率虽不高但较为显著,而TFR2、SCL40A1、HJV、HAMP、BMP6和SLC11A1基因的突变似乎很重要。本研究提出了一种适用于巴西铁过载调查和管理的算法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ef/12131004/1c3d0034b6b8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ef/12131004/1c3d0034b6b8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ef/12131004/1c3d0034b6b8/gr1.jpg

相似文献

[1]
Iron overload is not the same everywhere: Particularities of iron-metabolism gene mutations in Brazil and a proposal for the investigation and management of iron overload in this population.

Hematol Transfus Cell Ther. 2025

[2]
Hereditary hemochromatosis: mutations in genes involved in iron homeostasis in Brazilian patients.

Blood Cells Mol Dis. 2011-4-15

[3]
[Hereditary and acquired iron overload].

Nephrol Ther. 2006-11

[4]
Analysis of HFE and non-HFE gene mutations in Brazilian patients with hemochromatosis.

Clinics (Sao Paulo). 2009

[5]
Hereditary hemochromatosis in a Brazilian university hospital in São Paulo State (1990-2000).

Genet Mol Res. 2005-3-31

[6]
Hepatic iron metabolism gene expression profiles in HFE associated hereditary hemochromatosis.

Blood Cells Mol Dis. 2007

[7]
Iron overload and prolonged ingestion of iron supplements: clinical features and mutation analysis of hemochromatosis-associated genes in four cases.

Am J Hematol. 2006-10

[8]
Mutations in the HFE, TFR2, and SLC40A1 genes in patients with hemochromatosis.

Gene. 2012-8-4

[9]
Hemojuvelin and hepcidin genes sequencing in Brazilian patients with primary iron overload.

Genet Test Mol Biomarkers. 2010-12

[10]
HFE, SLC40A1, HAMP, HJV, TFR2, and FTL mutations detected by denaturing high-performance liquid chromatography after iron phenotyping and HFE C282Y and H63D genotyping in 785 HEIRS Study participants.

Am J Hematol. 2009-11

本文引用的文献

[1]
Investigation of BMP6 mutations in Brazilian patients with iron overload.

Hematol Transfus Cell Ther. 2024-11

[2]
genotypes, haemochromatosis diagnosis and clinical outcomes at age 80 years: a prospective cohort study in the UK Biobank.

BMJ Open. 2024-3-13

[3]
Hereditary hemochromatosis beyond hyperferritinemia: Clinical and laboratory investigation of the patient's profile submitted to phlebotomy in two reference centers in southern Brazil.

Genet Mol Biol. 2023-5-22

[4]
Haemochromatosis.

Lancet. 2023-5-27

[5]
Consensus Statement on the definition and classification of metabolic hyperferritinaemia.

Nat Rev Endocrinol. 2023-5

[6]
EASL Clinical Practice Guidelines on haemochromatosis.

J Hepatol. 2022-8

[7]
Genetic modifiers of penetrance to liver endpoints in HFE hemochromatosis: Associations in a large community cohort.

Hepatology. 2022-12

[8]
HFE hemochromatosis: an overview about therapeutic recommendations.

Hematol Transfus Cell Ther. 2022

[9]
Hemochromatosis classification: update and recommendations by the BIOIRON Society.

Blood. 2022-5-19

[10]
Hemochromatoses.

J Hepatol. 2021-9

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