Blog de la Hemocromatosis (Haemochromatosis). Hemocromatosis = exceso de hierro en sangre

We observed that cholecalciferol is more efficient than ergocalciferol and, when delivered at a high dose (500 IU/kg/day), cholecalciferol induces a significant locomotor and electrophysiological recovery. We also demonstrated that cholecalciferol increases i) the number of preserved or newly formed axons in the proximal end, ii) the mean axon diameter in the distal end, and iii) neurite myelination in both distal and proximal ends. Finally, we found a modified expression of several genes involved in axogenesis and myelination, after 24 hours of vitamin supplementation. Our study is the first to demonstrate that vitamin D acts on myelination via the activation of several myelin-associated genes. It paves the way for future randomised controlled clinical trials for peripheral nerve or spinal cord repair. La disminución de vitamina D circulante provocada por el hígado atacado por la hemocromatosis, podría ser la causa de la neuropatía. Probaremos si esto mejora administran...

Low serum 25-hydroxyvitamin D in hereditary hemochromatosis: relation to iron status. Chow LH , Frei JV , Hodsman AB , Valberg LS . Abstract Under normal conditions, vitamin D absorbed from the diet or synthesized in the skin is transported to the liver where it undergoes hydroxylation . The purpose of this study was to determine whether excess hepatic iron affects this process and the subsequent production of 1,25-dihydroxyvitamin D (1,25-[OH]2D) in the kidney. Mean serum 25-hydroxyvitamin D (25-OHD) concentrations in untreated hereditary hemochromatosis were 13 +/- 6 (SD) in 9 patients with cirrhosis, 13 +/- 6 in 5 patients with hepatic fibrosis, and 22 +/- 6 in 10 patients with normal hepatic architecture aside from siderosis and were significantly lower than the levels found in 24 controls matched for age, sex, and season, p less than 0.05. The mean serum 25-OHD levels in the two groups with hemochromatosis and hepatic damage were significantly lower than the...

Haemochromatosis is mostly caused by people inheriting 2 abnormal (mutated) copies of the HFE gene. The mutation is called pC2829Y. Researchers looked at information for nearly 500,000 people in the general population in the UK and found that around 1 in 156 people carried 2 pC2829Y mutations . These people had higher rates of various conditions like liver disease, arthritis and diabetes than those without 2 mutations. By the end of follow-up, 21% of men and 10% of women carrying 2 abnormal mutations had been diagnosed with haemochromatosis. Homozygous men carrying 2 abnormal variants were more likely than men without to have a range of linked conditions at the start of the study: 14.1% had osteoarthritis, compared to 7.5% without the mutation  2.4% had liver disease compared to 0.5% without (OR 4.30, 95% CI 2.99 to 6.18) 2% had rheumatoid arthritis compared to 0.9% without (OR 2.23, 95% CI 1.51 to 3.30) 4.7% had diabetes compared to 3.15% without (OR 1.51, 95% CI 1.1...

The usual treatment in HH is weekly phlebotomy until serum ferritin is less than 100 microgramos por mililitro. For patients presenting with heart failure, continous intravenous deferoxamine. Deferasirox is an effective oral quelator for removing hepatic iron (NEJM nov 29 2018.)

Idiopathic polyneuropathy was diagnosed in a relative large number of patients with Hereditary Haemochromatosis (26%), but the causal relationship needs to be confirmed in larger (case-control) series. (2010) J. of Neurology International BioIron Society - 8va conferencia  EMBL Heidelberg, Germany 5 - 10 May 2019. Un estudio de 1972 relaciona enfermedad hepática con neuropatia:      Neuropathy was f ound   most   frequently   in   alcoh olic   cirrhosis   and haemochromatosis   but   the   numbe rs   in some   of   the aetiological   groups   were   relat ively   small.   None   of   the   patients   with   haem ochromatosis had had   a   history   of   significant   a lcohol   intake.  

La hepcidina es la proteína que regula la absorción de hierro en el duodeno. Esta proteína sintética, LJPC-401 se está probando en diferentes lugares del mundo. La hepcidina es un péptido que deriva de un precursor de 84 aminoácidos sintetizado por el hígado y cuyo origen genético se encuentra en el gen número 19. Su nombre deriva de hepatic bactericidal protein. Tiene una leve acción bactericida y antimicótica. El páptido hepcidina tiene entre 20 y 24 aminoácidos de los cuales 8 son cisteínas. Se supone que son las cisteínas las que le confieren el carácter antibacteriano. Se ha visto que su expresión también es regulada por el gen HFE y por el factor de transcripción C/EBP a ( enhancer binding protein ). Algunos autores proponen que el hígado desempeña un papel central en el mantenimiento de la homeostasia del hierro por regular la expresión de la hepcidina en respuesta a los cambios en la relación transferrina diférrica circulante: receptor de transferrina...

Leo esto en twitter: Clinical  trials have begun worldwide for a potential treatment using a synthetic  human hepcidin called LJPC-401, being developed by La Jolla Pharmaceutical. Recruitment for the trials is happening in US, UK, France, Australia. Obviamente, no es posible anotarse viviendo en Argentina. Pero esto es un enorme avance.