Increased number of endothelial progenitors in peripheral blood as a possible early marker of tumour growth in post-menopausal breast cancer patients.

The aim of the study was to evaluate the number of circulating endothelial progenitor cells (circulating EPCs) in the blood of patients diagnosed with breast cancer and to make an attempt at finding associations with the number of circulating EPCs and selected clinic-pathological factors; TNM and histological grading, molecular subtype of breast cancer, hormonal status, the expression of Ki-67 and the size of tumour. The study involved 96 Caucasian ethnicity post-menopausal women. Sixty-six women aged 48 - 63 (mean age 55) with breast cancer diagnosis without distant metastases (M0). The median value of the tumour diameter was 1.51 cm. The control group consisted of 30 healthy, non-smoking, post-menopausal women, mean age 49, range 44 - 54 years of age. The exclusion criteria for all the participants were hypertension, hyperlipidaemia, and hyperglycaemia, acute and chronic infection. With regard to the fresh blood samples the number of circulating endothelial progenitors was determined using flow cytometry. The fluorescence of 100,000 cells was measured during the analysis. Circulating EPCs were identified with the immune-phenotype CD45-, CD34+, CD133+, CD31+. A significantly higher number of circulating EPCs in the study group, as compared to the controls (P = 0.0001) and a significantly higher number of circulating EPCs in women over 60 with breast cancer than in the younger women (P = 0.0029) were reported. A positive correlation was noted between circulating EPCs and age as well as between circulating EPCs and HER-2 (P = 0.0231, P = 0.0414, respectively), and a negative correlation between circulating EPCs and histological grading of breast cancer (P = 0.0272). The study has shown a higher number of circulating EPCs in breast cancer patients, which indicates stimulation of neovascularization. Additionally, since bone morrow-derived circulating EPCs are more intensively mobilised in older and overweight breast cancer patients, we can speculate that more aggressive neo-angiogenesis can occur in those patients.

Prohepcidin and iron metabolism parameters in the obese elderly patients with anemia.

OBJECTIVE: To examine the impact of a body fat content on the concentration of a serum prohepcidin, iron metabolism parameters and inflammation markers in elderly patients with microcytic or normocytic anemia. DESIGN: Clinical study with biochemical and anthropometric measurements. SUBJECTS: Fifty two elderly patients (19 male, 33 female) with anemia, 65-91 years of age. MEASUREMENTS: Prohepcidin, ferritin, soluble transferrin receptor, erythropoietin and interleukin-6 were measured using commercially available ELISA kits. Iron, TIBC, transferrin, C-reactive protein and complete blood count were assayed using standard laboratory methods. Body fat content, fat distribution and protein nutrition state parameters were assessed by means of anthropometry. RESULTS: Mean serum prohepcidin levels were significantly higher in patients with high body fat content in comparison to patients with normal body fat content (224,85 vs 176,6 ng/ml). Prohepcidin levels of the elderly patients with anemia were positively correlated with biceps, subscapular and suprailiac skinfold thickness or body fat mass percentage. In our study serum prohepcidin levels do not correlate with any iron parameters or inflammation markers. CONCLUSION: Summing up, the results of this study indicate that increased prohepcidin concentration, observed in obese elderly patients with anemia, may play an important role in iron deficiency development.

Pro-hepcidin and iron metabolism parameters in multi-time blood donors.

A high number of blood donations may cause iron depletion. The pathophysiology behind this process may involve hepcidin, a recently discovered peptide that acts by inhibiting iron absorption and promoting iron retention in reticuloendothelial macrophages. The aim of this study was to determine serum pro-hepcidin levels and iron metabolism parameters in multi-time blood donors. The study group consisted of 132 multi-time male blood donors and 25 healthy male volunteers (nondonors). Complete blood cell count and iron status including serum iron, ferritin, soluble transferrin receptor (sTfR), total iron binding capacity (TIBC), unsaturated iron binding capacity (UIBC), erythropoietin and pro-hepcidin (ELISA) were assessed. In blood donors, ferritin level drops markedly in relation to donation frequency (P < 0.001). In contrast, TIBC and UIBC levels increase progressively corresponding to annual donation frequency. Pro-hepcidin concentration increases significantly with the number of donations per year (P = 0.0290). In blood donors having donated blood with the highest frequency per year, pro-hepcidin levels were positively correlated with haemoglobin (R = 0.31, P < 0.05) and negatively with sTfR (R = -0.31, P < 0.05). Pro-hepcidin levels increase in relation to blood donation frequency per year. Longitudinal studies focusing on changes in serum hepcidin levels are required to address the question whether hepcidin may contribute to iron metabolism disturbances in multi-times blood donors.