Discriminating Between IDA and ACD using TfR as Indikators of Iron Status an oxydative balance

The concentrations of the TfR (soluble receptor for transferrin) positively correlated with total mass of tissue receptors, increased in response to a deficiency of iron and, conversely, negatively correlated with the content of cellular iron. Methods: Blood was collected from children with iron/nutritive deficient anemia,(n=20), IDA group, from children with inflammations and/ or recurrent infections (n=53) with anemia syndrome, ACD group, and from healthy controls (n=19). Serum concentrations of soluble transferrin receptor were determined using the QuantikineIVD Human immunoassay kit (R&D Systems) in nmol/l. Plasma nitric oxide (NO) concentration was measured by Cayman Chemical′s photometric test (μmol/L). Results: The TfR concentration was increased (mean ± SD), 52,48 ± 21,36 in IDA patients, and was normal (29,67 ± 3,81) in controls and for more than 55% of the ACD patients (20,4±8). The TfR/log ferritin was significantly low (p< 0.001) in the ACD group, 11,82±5,68 compared to IDA (55,46±33,16) and controls (24,40±3,49),while NO value were extremely high in the ACD group: 123±41 vs IDA 70±49; Control 49±12. Conclusion: The determination of sTfR is necessary in the differential diagnosis of these two anemias. One explanation proposed for this inadequate sTfR secretion is that the anemia is adaptive; to reflects a reduced rate of oxygen use by tissues in response to increased oxidative stress induced by pro-inflammatory state of the organism. One colorful description of this process is that the "hematologic thermostat has been turned down a bit".