Interaction of inflammatory cytokines and erythropoeitin in iron metabolism and erythropoiesis in anaemia of chronic disease

In chronic inflammatory conditions increased endogenous release of specific cytokines (TNFα, IL-1, IL-6, IFNγ and others) is presumed. It has been shown that those of monocyte lineage play a key role in cytokine expression and synthesis. This may be associated with changes in iron metabolism and impaired erythropoiesis and may lead to development of anaemia in patients with rheumatoid arthritis. Firstly, increased synthesis of acute phase proteins, like ferritin, during chronic inflammation is proposed as the way by which the toxic effect of iron and thereby the synthesis of free oxy-radicals causing the damage on the affected joints, may be reduced. This is associated with a shift of iron towards the mononuclear phagocyte system which may participate in the development of anaemia of chronic disease. Secondly, an inhibitory action of inflammatory cytokines (TNFα, IL-1), on proliferation and differentiation of erythroid progenitors as well as on synthesis of erythropoietin has been shown, thereby also contributing to anaemia. Finally, chronic inflammation causes multiple, complex disturbances in the delicate physiologic equilibrium of interaction between cytokines and cells (erythroid progenitors, cells of mononuclear phagocyte system and erythropoietin producing cells) leading to development of anaemia of chronic disease (Fig. 1)

Consequences of bullying on adolescents’ mental health in Germany : comparing face-to-face bullying and cyberbullying

The present study explored whether face-to-face bullying (physical as well as relational), cyberbullying, and teachers’ bullying have a negative impact on adolescent’s mental health and whether there are gender differences. Analyses are based on a representative cross-sectional standardised survey of 10,638 students of the nineth grade of one federal state of Germany. Findings show that psychological cyberbullying is most strongly associated with poor mental health for both boys and girls. Relational bullying by classmates as well as by teachers also show a significant correlation with poor mental health. For girls, there appears to be an additional relationship between sexual cyberbullying and mental health. Physical forms of bullying were not found to be associated with mental health. Implications for research are discussed