Hepcidin: SNP-Like Polymorphisms Present in Iron Metabolism and Clinical Complications of Iron Accumulation and Deficiency

The metabolism of iron is regulated by the peptide hormone hepcidin. Genetic alterations in the proteins involved in the signalling pathway and hepcidin transcription cause damage to the organism. Mutations and polymorphisms in the hepcidin antimicrobial peptide(HAMP), HFE, HJV, ferroportin and matriptase-2 genes influence serum hepcidin concentration. Genetic deficiency of hepcidin increases iron overload in tissues, leading to haemochromatosis. However, genetics changes in the TMPRSS6 gene promote an increase in serum hepcidin, with the development of severe anaemia and resistance to iron treatment, as observed in IRIDA. Making the flow and efflux of extracellular and intracellular iron is impossible. To date, no drug that works by inhibiting or enhancing hepcidin transcription is available, largely because of the cytotoxicity described in vitro models. The proposed therapeutic targets are still in the early stages of clinical trials, some are good candidates, such as heparin derivatives and mini-hepcidins

Regulatory T Lymphocytes (Treg): Modulation and Clinical Application

Treg cells CD4+CD25+FOXP3+ have a specific function in the tolerance of autoantigens and regulation of the immune response. Modulation of differentiation pathways and the use of Treg cells in cell therapy have been reported in autoimmune diseases, systemic lupus erythromatosis, autoimmune hepatitis, type 1 diabetes mellitus, multiple sclerosis, rheumatoid arthritis, graft-versus-host disease, bone marrow transplantation and solid organs. The expansion of Treg cells in vivo occurs through low-dose IL-2 treatment. However, because of the heterogeneity and variability of Treg cells, the isolation of peripheral blood cells, through the technique of leucopheresis by GMP (good manuring practice), for in vitro expansion is difficult, necessitating a large combination of specific and reliable cellular markers. Currently, two specific markers, Helios and neuropilin-1, are being studied to facilitate the differentiation of thymus Treg cells and peripheral Treg cells. However, Treg cells induced in vitro are unstable. Modulation of the FOXP3 gene in the CNS1 and CNS2 region is an alternative to maintaining the stability of expanded Treg cells in vitro

Influence of Hepcidin in the Development of Anemia

Anemia presents a global public health problem. It is related to several factors, ranging from deficiency in nutrients from food to genetic alterations in iron absorption and metabolism. In this context, hepcidin is a peptide molecule that regulates iron homeostasis. Hepcidin is synthesized, in part, by hepatocytes. In physiological conditions, increased serum transferrin, serum iron, inflammation, and erythropoiesis trigger stimuli that promote hepcidin antimicrobial peptide (HAMP) gene transcription and hepcidin synthesis. However, in pathological situations, an overexpression of hepcidin occurs, an increase in the plasma concentration that damages the organism. Hepcidin contributes to the pathogenesis of iron deficiency anemia, anemia of inflammation, in hemoglobinopathies. Then, there is a restriction of the availability of iron to the tissues and the formation of new erythroid precursors, with the consequent development of anemia

Finding connections in the unexpected detection of Plasmodium vivax and Plasmodium falciparum DNA in asymptomatic blood donors: a fact in the Atlantic Forest

Abstract\ud A recent paper in Malaria Journal reported the observation of unexpected prevalence rates of healthy individuals carrying Plasmodium falciparum (5.14%) or Plasmodium vivax (2.26%) DNA among blood donors from the main transfusion centre in the metropolitan São Paulo, a non-endemic area for malaria. The article has been challenged by a group of authors who argued that the percentages reported were higher than those found in blood banks of the endemic Amazon Region and also that that paper had not considered the literature on the classical dynamics of malaria transmission in the Atlantic Forest, which involves Anopheles (Kerteszia) cruzii and bromeliad malaria, due to P. vivax and Plasmodium malariae parasites, but not P. falciparum. The present commentary paper responds to this challenge and brings evidence and literature data supporting that the observed prevalence ratios may indicate a proportion of individuals that are exposed to Plasmodium transmission in permissive environments; that blood carrying parasite DNA may not be necessarily infective if used in transfusion; and that in the literature, there are examples supporting the circulation of P. falciparum in the area.FAPES

Plasmodium falciparum in the southeastern Atlantic forest: a challenge to the bromeliad-malaria paradigm?

Abstract\ud \ud Background\ud Recently an unexpectedly high prevalence of Plasmodium falciparum was found in asymptomatic blood donors living in the southeastern Brazilian Atlantic forest. The bromeliad-malaria paradigm assumes that transmission of Plasmodium vivax and Plasmodium malariae involves species of the subgenus Kerteszia of Anopheles and only a few cases of P. vivax malaria are reported annually in this region. The expectations of this paradigm are a low prevalence of P. vivax and a null prevalence of P. falciparum. Therefore, the aim of this study was to verify if P. falciparum is actively circulating in the southeastern Brazilian Atlantic forest remains.\ud \ud \ud Methods\ud In this study, anophelines were collected with Shannon and CDC-light traps in seven distinct Atlantic forest landscapes over a 4-month period. Field-collected Anopheles mosquitoes were tested by real-time PCR assay in pools of ten, and then each mosquito from every positive pool, separately for P. falciparum and P. vivax. Genomic DNA of P. falciparum or P. vivax from positive anophelines was then amplified by traditional PCR for sequencing of the 18S ribosomal DNA to confirm Plasmodium species. Binomial probabilities were calculated to identify non-random results of the P. falciparum-infected anopheline findings.\ud \ud \ud Results\ud The overall proportion of anophelines naturally infected with P. falciparum was 4.4% (21/480) and only 0.8% (4/480) with P. vivax. All of the infected mosquitoes were found in intermixed natural and human-modified environments and most were Anopheles cruzii (22/25 = 88%, 18 P. falciparum plus 4 P. vivax). Plasmodium falciparum was confirmed by sequencing in 76% (16/21) of positive mosquitoes, whereas P. vivax was confirmed in only 25% (1/4). Binomial probabilities suggest that P. falciparum actively circulates throughout the region and that there may be a threshold of the forested over human-modified environment ratio upon which the proportion of P. falciparum-infected anophelines increases significantly.\ud \ud \ud Conclusions\ud These results show that P. falciparum actively circulates, in higher proportion than P. vivax, among Anopheles mosquitoes of fragments of the southeastern Brazilian Atlantic forest. This finding challenges the classical bromeliad-malaria paradigm, which considers P. vivax circulation as the driver for the dynamics of residual malaria transmission in this region.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP Grant 2011/20397-7), (Grant 2009/53141-5), (Grant 012/09939-5) e (Grant 2014/09774-1)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq no. 301666/2011-3

Frequency of the Paraoxonase 1 and 2 genetic polymorphisms and analysis of the lipid peroxidation in plasma of HIV positive patients

A paraoxonase sérica humana (PON) vem sendo amplamente estudada. Além da capacidade de PON1 em hidrolisar compostos organofosfatados, sabe-se, atualmente, que toda a família PON (composta por PON1, PON2 e PON3) promove a proteção de lípides, incluindo-se a lipoproteína de baixa densidade (LDL) contra a oxidação. O gene da PON1 sérica apresenta dois sítios polimórficos bem determinados: a troca Gln192Arg (Q/R) e Met55Leu, os quais estão associados com diferenças na atividade e concentrações séricas da enzima, respectivamente. Também o polimorfismo Cys311Ser parece contribuir sinergisticamente com o alelo PON1-192R quanto ao risco cardiovascular em algumas populações. Já foi demonstrado, por sua vez, que pacientes infectados pelo vírus HIV podem desenvolver dislipidemia e que tanto a atividade como a concentração de PON1 podem ser influenciadas por esta infecção. O objetivo deste estudo foi determinar as freqüências alélicas dos polimorfismos genéticos PON1-192QR, PON1-55LM, PON2-311SC e PON2-148AG, bem como avaliar a atividade de PON1 e a peroxidação lipídica no plasma de indivíduos portadores de HIV. Materiais e Métodos após aprovação pela comissão de ética e da aplicação do termo de consentimento pós-esclarecido, 350 (264 homens e 86 mulheres) pacientes infectados pelo HIV foram incluídos no estudo. Foi avaliado ainda um grupo de 32 (23 homens e 9 mulheres) indivíduos recentemente diagnosticados como portadores do vírus. Uma população saudável composta por 179 doadores de sangue, todos de sexo masculino, foi avaliada como controle. Após a extração do DNA, procedeu-se à genotipagem para os polimorfismos de PON1 e PON2 através de PCR-RFLP. A atividade paraoxonase de PON1 foi avaliada por espectrofotometria empregando-se paraoxon como substrato. O colesterol total, VLDL-colesterol, HDL-colesterol e triglicérides foram determinados por métodos padrão. A fração LDL-colesterol foi calculada pela fórmula de Friedwald. Resultados As freqüências alélicas para os polimorfimos de PON1 nos pacientes foram: 36,43% para o alelo PON1-192R, 57,86% para PON1-55L, 65,57% para PON2-311S e 76,43% para o alelo PON2-148A. No grupo de indivíduos recentemente diagnosticados como portadores de HIV estas freqüências foram 37,50%, 51,56%, 81,25% e 68,75, respectivamente. No grupo composto pelos saudáveis, a freqüência alélica de PON1-192R foi 43,02%, a de PON1-55L foi 68,99%, a do alelo PON2-311S foi 67,60% e, por fim, a freqüência do alelo PON2-148A foi 75,14%. Conclusões As distribuições alélicas dos polimorfimos em PON1 e PON2 foram similares dentre os portadores de HIV e os controles. A relação entre os genótipos PON1-192QR e/ou PON1-55LM e a atividade de PON1 em pacientes não diferiu daquela observada nos controles. Observou-se ainda, aumento do colesterol, dos triglicérides e da peroxidação lipídica no plasma dos infectados pelo vírus e, nos pacientes, uma maior atividade enzimática dentre os possuidores de contagem de linfócitos CD4+ acima de 500 células por mm3.Human serum paraoxonase (PON) has been the subject of a number of studies. Beside the capacity of PON1 in hydrolyzing organophosphate compounds, it is known now that the entire PON family (which comprises PON1, PON2 and PON3) protects lipids, including low-density lipoprotein (LDL), from oxidation. Serum PON1 gene presents two well-determined genetic polymorphic sites: a Gln192 Arg (Q/R) and Met55 Leu, which are associated with differences in enzymatic activity and serum concentrations, respectively. Moreover, PON2 Cys311 Ser polymorphism seems to contribute synergistically with PON-192R allele to cardiovascular risk in some populations. It has been shown that HIV infected patients may develop dyslipidemia and that PON1 activity and concentration may be influenced by this infection. The aim of this study was to determine allelic frequencies of PON1-192QR, PON1-55LM, PON2-311SC and PON2-148AG genetic polymorphisms, evaluate PON1 activity and lipid peroxidation in plasma of HIV patients. Methods and Subjects after ethical committee approval and written consent, 350 (264 men and 86 women) HIV infected patients were included in the study. It was also evaluated a group of 32 recently diagnosed HIV individuals (23 men and 9 women). As controls, a healthy population formed by 179 men, blood donors, was studied. After DNA extraction PON1 and PON2 genotyping were performed by PCR-RFLP. Paraoxonase activity of PON1 was evaluated spectrofotometrically using paraoxon as substrate. Serum cholesterol, VLDL-cholesterol, HDL-cholesterol and triglycerides were analyzed by standard methods. LDL-cholesterol was calculated by Friedewald formula. Results: Allelic frequencies for PON1 polymorphisms in patients were: 36,43% for PON1-192R, 57,86% for PON1-55L, 65,57% for PON2-311S and 76,43% for PON2-148A. In recently diagnosed individuals these frequencies were 37,50%, 51,56%, 81,25% and 68,75% respectively. In controls, PON1-192R allelic frequency was 43,02%, PON1-55L was 68,99%, PON2-311S was 67,60% and PON2-148A was 75,14%. Conclusion: Allelic distributions of PON1 and PON2 polymorphisms were similar in HIV patients and controls. The relationship between PON1-192 QR and/or PON1-55LM genotypes and enzyme activity in patients were not different from controls. It was also observed an elevation of cholesterol, tryglicerides and lipid peroxidation levels in plasma of infected patients and, in this group, a higher activity in those which CD4+ cells counting was more than 500 cell/mm3

Frequency of the Paraoxonase 1 and 2 genetic polymorphisms and analysis of the lipid peroxidation in plasma of HIV positive patients

A paraoxonase sérica humana (PON) vem sendo amplamente estudada. Além da capacidade de PON1 em hidrolisar compostos organofosfatados, sabe-se, atualmente, que toda a família PON (composta por PON1, PON2 e PON3) promove a proteção de lípides, incluindo-se a lipoproteína de baixa densidade (LDL) contra a oxidação. O gene da PON1 sérica apresenta dois sítios polimórficos bem determinados: a troca Gln192Arg (Q/R) e Met55Leu, os quais estão associados com diferenças na atividade e concentrações séricas da enzima, respectivamente. Também o polimorfismo Cys311Ser parece contribuir sinergisticamente com o alelo PON1-192R quanto ao risco cardiovascular em algumas populações. Já foi demonstrado, por sua vez, que pacientes infectados pelo vírus HIV podem desenvolver dislipidemia e que tanto a atividade como a concentração de PON1 podem ser influenciadas por esta infecção. O objetivo deste estudo foi determinar as freqüências alélicas dos polimorfismos genéticos PON1-192QR, PON1-55LM, PON2-311SC e PON2-148AG, bem como avaliar a atividade de PON1 e a peroxidação lipídica no plasma de indivíduos portadores de HIV. Materiais e Métodos após aprovação pela comissão de ética e da aplicação do termo de consentimento pós-esclarecido, 350 (264 homens e 86 mulheres) pacientes infectados pelo HIV foram incluídos no estudo. Foi avaliado ainda um grupo de 32 (23 homens e 9 mulheres) indivíduos recentemente diagnosticados como portadores do vírus. Uma população saudável composta por 179 doadores de sangue, todos de sexo masculino, foi avaliada como controle. Após a extração do DNA, procedeu-se à genotipagem para os polimorfismos de PON1 e PON2 através de PCR-RFLP. A atividade paraoxonase de PON1 foi avaliada por espectrofotometria empregando-se paraoxon como substrato. O colesterol total, VLDL-colesterol, HDL-colesterol e triglicérides foram determinados por métodos padrão. A fração LDL-colesterol foi calculada pela fórmula de Friedwald. Resultados As freqüências alélicas para os polimorfimos de PON1 nos pacientes foram: 36,43% para o alelo PON1-192R, 57,86% para PON1-55L, 65,57% para PON2-311S e 76,43% para o alelo PON2-148A. No grupo de indivíduos recentemente diagnosticados como portadores de HIV estas freqüências foram 37,50%, 51,56%, 81,25% e 68,75, respectivamente. No grupo composto pelos saudáveis, a freqüência alélica de PON1-192R foi 43,02%, a de PON1-55L foi 68,99%, a do alelo PON2-311S foi 67,60% e, por fim, a freqüência do alelo PON2-148A foi 75,14%. Conclusões As distribuições alélicas dos polimorfimos em PON1 e PON2 foram similares dentre os portadores de HIV e os controles. A relação entre os genótipos PON1-192QR e/ou PON1-55LM e a atividade de PON1 em pacientes não diferiu daquela observada nos controles. Observou-se ainda, aumento do colesterol, dos triglicérides e da peroxidação lipídica no plasma dos infectados pelo vírus e, nos pacientes, uma maior atividade enzimática dentre os possuidores de contagem de linfócitos CD4+ acima de 500 células por mm3.Human serum paraoxonase (PON) has been the subject of a number of studies. Beside the capacity of PON1 in hydrolyzing organophosphate compounds, it is known now that the entire PON family (which comprises PON1, PON2 and PON3) protects lipids, including low-density lipoprotein (LDL), from oxidation. Serum PON1 gene presents two well-determined genetic polymorphic sites: a Gln192 Arg (Q/R) and Met55 Leu, which are associated with differences in enzymatic activity and serum concentrations, respectively. Moreover, PON2 Cys311 Ser polymorphism seems to contribute synergistically with PON-192R allele to cardiovascular risk in some populations. It has been shown that HIV infected patients may develop dyslipidemia and that PON1 activity and concentration may be influenced by this infection. The aim of this study was to determine allelic frequencies of PON1-192QR, PON1-55LM, PON2-311SC and PON2-148AG genetic polymorphisms, evaluate PON1 activity and lipid peroxidation in plasma of HIV patients. Methods and Subjects after ethical committee approval and written consent, 350 (264 men and 86 women) HIV infected patients were included in the study. It was also evaluated a group of 32 recently diagnosed HIV individuals (23 men and 9 women). As controls, a healthy population formed by 179 men, blood donors, was studied. After DNA extraction PON1 and PON2 genotyping were performed by PCR-RFLP. Paraoxonase activity of PON1 was evaluated spectrofotometrically using paraoxon as substrate. Serum cholesterol, VLDL-cholesterol, HDL-cholesterol and triglycerides were analyzed by standard methods. LDL-cholesterol was calculated by Friedewald formula. Results: Allelic frequencies for PON1 polymorphisms in patients were: 36,43% for PON1-192R, 57,86% for PON1-55L, 65,57% for PON2-311S and 76,43% for PON2-148A. In recently diagnosed individuals these frequencies were 37,50%, 51,56%, 81,25% and 68,75% respectively. In controls, PON1-192R allelic frequency was 43,02%, PON1-55L was 68,99%, PON2-311S was 67,60% and PON2-148A was 75,14%. Conclusion: Allelic distributions of PON1 and PON2 polymorphisms were similar in HIV patients and controls. The relationship between PON1-192 QR and/or PON1-55LM genotypes and enzyme activity in patients were not different from controls. It was also observed an elevation of cholesterol, tryglicerides and lipid peroxidation levels in plasma of infected patients and, in this group, a higher activity in those which CD4+ cells counting was more than 500 cell/mm3