Causes of iron overload in blood donors - a clinical study.

BACKGROUND AND OBJECTIVES: Despite the obligate iron loss from blood donation, some donors present with hyperferritinaemia that can result from a wide range of acute and chronic conditions including hereditary haemochromatosis (HH). The objective of our study was to investigate the causes of hyperferritinaemia in the blood donor population and explore the value of extensive HH mutational analyses. MATERIALS AND METHODS: Forty-nine consecutive donors (f = 6, m = 43) were included prospectively from the Capital Regional Blood Center. Inclusion criteria were a single ferritin value >1000 µg/l or repeated hyperferritinaemia with at least one value >500 µg/l. All donors were questioned about their medical history and underwent a physical examination, biochemical investigations and next-generation sequencing of HH-related genes, including the HFE gene, the haemojuvelin gene (HFE2/HJV), the hepcidin gene (HAMP), the ferroportin 1 gene (SLC40A1) and the transferrin receptor 2 gene (TFR2). RESULTS: Forty of 49 donors were mutation positive with a combined 69 mutations, 54 of which were located in the HFE gene. There were 11 mutations in the TFR2 gene, two mutations in the HFE2 gene and two mutations in the HAMP gene. Only four donors had apparent alternative causes of hyperferritinaemia. CONCLUSION: HH-related mutations were the most frequent cause of hyperferritinaemia in a Danish blood donor population, and it appears that several different HH-genotypes can contribute to hyperferritinaemia. HH screening in blood donors with high ferritin levels could be warranted. HH-related iron overload should not in itself result in donor ineligibility.

A distal Sp1-element is necessary for maximal activity of the human gastrin gene promoter.

Studies of transgenic mice have shown that transcriptional control of the gastrin gene exhibits significant species differences. Transfection of the human gastrin promoter in murine cells have depicted proximal Sp1, E-box and CACC elements as the major determinants of transcription. We have examined cis-regulatory elements of the human promoter on a human gastrin expressing cell line and find that a distal -135 to -142 Sp1 element is necessary for maximal activity. Alignment of the mouse and human promoters shows that the proximal human Sp1 and CACC elements are not conserved, whereas the E-box element is retained. The distal Sp1 element is present in mouse but exhibits a C to T transition in the core that is likely to reduce binding affinity of Sp1. We conclude that gastrin gene transcription is regulated by distinct elements in man and rodents.

Composite action of three GC/GT boxes in the proximal promoter region is important for gastrin gene transcription.

The proximal region of the human gastrin gene promoter contains three GC/GT boxes at positions -140 to -134 bp, -108 to -102 bp and -67 to -61 bp. In this study we have examined the significance of the three elements, and their role in Sp1 and Sp3 mediated gastrin transcription. In AGS cells, mutation of each of the boxes caused a moderate decrease in promoter activity from 33 to 63%, whereas double or triple mutations reduced activity to 3-12%. In Drosophila cells Sp1 activated the promoter, mainly through the distal GC box. Similarly, co-transfection of heterologous promoter constructs revealed that only the distal GC box increased activation by Sp1. The effect of Sp3 was cell-line dependent, since Sp3 inhibited the gastrin promoter activity in AGS cells and caused a synergistic activation of the Sp1 stimulated gastrin promoter in Drosophila cells. Both effects were dependent on the C-terminal DNA binding domain of Sp3. The results indicates that the combined effect of the GC/GT boxes and the ratio between Sp1 and Sp3 are important for gastrin gene expression.

Total parenteral nutrition in four healthy adult horses.

Total parenteral nutrition was accomplished in 4 healthy adult horses. During the 10-day study, the horses were not permitted to ingest food or water. Body weight was maintained at 94% of initial values without clinical evidence of dehydration. Serum urea nitrogen and triacylglycerol concentrations decreased during the study, without other significant hematologic or biochemical changes. Horses adapted without problems to the routine of IV feeding and confinement. All horses were healthy at the conclusion of the study. It was concluded that intravenous feeding with a lipid-glucose-amino acid-electrolyte solution was an acceptable method of maintaining nutrition in the healthy adult horse.

Use of a liquid diet as the sole source of nutrition in six dysphagic horses and as a dietary supplement in seven hypophagic horses.

Six horses with dysphagia (attributable to botulism, glossitis, or guttural pouch mycosis) were given a commercially available liquid diet as the sole source of nutrition. Seven horses with hypophagia caused by severe bacterial pleuropneumonia or peritonitis were given the liquid diet to supplement food consumed voluntarily. The liquid diet was administered through a nasogastric tube 2 or 3 times daily. Body weight did not change significantly, and pertinent laboratory values remained at satisfactory concentrations throughout the feeding period. Serious complications were not encountered. Three horses developed loose, low-volume feces, but did not require treatment.

Clinical and clinicopathologic findings in two foals infected with Bacillus piliformis.

Bacillus piliformis infection (Tyzzer's disease) in foals is rarely observed clinically because of the peracute course of the disease. Clinical and clinicopathologic findings as well as information on therapeutic attempts in two foals are described. Clinicopathologic abnormalities common to both cases included leukopenia, hyperfibrinogenemia, metabolic acidosis, and hypoglycemia. Treatment was unsuccessful in both cases.

Cyclic AMP-induced neuronal differentiation via activation of p38 mitogen-activated protein kinase.

The p38 mitogen-activated protein kinase (MAPK) pathway mediates cellular responses to inflammatory cytokines and environmental stress, but recent studies have indicated that p38 MAPK may be involved in a more widespread set of cellular functions. Here we show that activation of the cyclic AMP (cAMP) pathway induces a rapid, dose-dependent phosphorylation and activation of p38 MAPK and that combined stimulation with forskolin and growth factors results in additive stimulation of p38 MAPK. Forskolin-stimulated neurite out-growth in rat pheochromocytoma PC12 cells was inhibited by the p38 MAPK inhibitor SB203580. With the combination of forskolin and nerve growth factor, neurite outgrowth was additively increased, and this effect was also inhibited by SB203580. Finally, transfection of p38AGF, which exhibits a mutated activation loop, inhibited cAMP-mediated neuronal differentiation. The results indicate that p38 MAPK is a downstream target of the cAMP signaling pathway and that p38 MAPK plays a key role in neuronal differentiation induced by cAMP and growth factors by integration of signals from both pathways.