Evaluation of kits for measurement of the soluble transferrin receptor

Åkesson, Agneta; Bjellerup, Per; Vahter, Marie

doi:10.1080/00365519950185788

Cited by 45 publications

(25 citation statements)

References 11 publications

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“…3) [7]. In subjects with elevated transferrin saturation [55,56], African iron overload [57,58] or genetic hemochromatosis [12,57,59], average sTfR levels are about 20% below those measured in normal subjects but most values are still within the normal range. Iron deficiency has a much stronger impact on sTfR levels [60].…”

Section: Soluble Tfr and Iron Statusmentioning

confidence: 99%

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

Béguin

2003

Clinica Chimica Acta

395

316

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Iron transport in the plasma is carried out by transferrin, which donates iron to cells through its interaction with a specific membrane receptor, the transferrin receptor (TfR). A soluble form of the TfR (sTfR) has been identified in animal and human serum. Soluble TfR is a truncated monomer of tissue receptor, lacking its first 100 amino acids, which circulates in the form of a complex of transferrin and its receptor. The erythroblasts rather than reticulocytes are the main source of serum sTfR. Serum sTfR levels average 5.0 F 1.0 mg/l in normal subjects but the various commercial assays give disparate values because of the lack of an international standard. The most important determinant of sTfR levels appears to be marrow erythropoietic activity which can cause variations up to 8 times below and up to 20 times above average normal values. Soluble TfR levels are decreased in situations characterized by diminished erythropoietic activity, and are increased when erythropoiesis is stimulated by hemolysis or ineffective erythropoiesis. Measurements of sTfR are very helpful to investigate the pathophysiology of anemia, quantitatively evaluating the absolute rate of erythropoiesis and the adequacy of marrow proliferative capacity for any given degree of anemia, and to monitor the erythropoietic response to various forms of therapy, in particular allowing to predict response early when changes in hemoglobin are not yet apparent. Iron status also influences sTfR levels, which are considerably elevated in iron deficiency anemia but remain normal in the anemia of inflammation, and thus may be of considerable help in the differential diagnosis of microcytic anemia. This is particularly useful to identify concomitant iron deficiency in a patient with inflammation because ferritin values are then generally normal. Elevated sTfR levels are also the characteristic feature of functional iron deficiency, a situation defined by tissue iron deficiency despite adequate iron stores. The sTfR/ferritin ratio can thus describe iron availability over a wide range of iron stores. With the exception of chronic lymphocytic leukemia (CLL) and high-grade non-Hodgkin's lymphoma and possibly hepatocellular carcinoma, sTfR levels are not increased in patients with malignancies. We conclude that soluble TfR represents a valuable quantitative assay of marrow erythropoietic activity as well as a marker of tissue iron deficiency. D

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Section: Soluble Tfr and Iron Statusmentioning

confidence: 99%

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

Béguin

2003

Clinica Chimica Acta

395

316

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“…The ratio of sTfR to ferritin (R/F ratio) has even been suggested as the gold standard. A drawback of the use of this ratio in medical practice, however, is the lack of appropriate standardization of the current sTfR assay (188 ). This necessitates that each laboratory calibrate the R/F ratio by quantitative phlebotomy measurements (189 ).…”

Section: Hepcidin In Hemochromatosismentioning

confidence: 99%

Hereditary Hemochromatosis: Genetic Complexity and New Diagnostic Approaches

et al. 2006

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Since the discovery of the hemochromatosis gene (HFE) in 1996, several novel gene defects have been detected, explaining the mechanism and diversity of iron-overload diseases. At least 4 main types of hereditary hemochromatosis (HH) have been identified. Surprisingly, genes involved in HH encode for proteins that all affect pathways centered around liver hepcidin synthesis and its interaction with ferroportin, an iron exporter in enterocytes and macrophages. Hepcidin concentrations in urine negatively correlate with the severity of HH. Cytokine-mediated increases in hepcidin appear to be an important causative factor in anemia of inflammation, which is characterized by sequestration of iron in the macrophage system. For clinicians, the challenge is now to diagnose HH before irreversible damage develops and, at the same time, to distinguish progressive iron overload from increasingly common diseases with only moderately increased body iron stores, such as the metabolic syndrome. Understanding the molecular regulation of iron homeostasis may be helpful in designing innovative and reliable DNA and protein tests for diagnosis. Subsequently, evidence-based diagnostic strategies must be developed, using both conventional and innovative laboratory tests, to differentiate between the various causes of distortions of iron metabolism. This review describes new insights in mechanisms of iron overload, which are needed to understand new developments in diagnostic medicine.

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“…Measuring sTfR levels, for which only a few microliters of serum are needed, would be especially useful at outpatient clinics. However, the sTfR level is a relatively new parameter, and, as suggested by a recent report evaluating the practicality, comparability, and ability to discriminate between presence or absence of iron deficiency of 3 commercially available sTfR kits, a need exists for internationally accepted reference material and comparable units (34). We studied a larger group well characterized regarding iron status, thereby minimizing uncertainties.…”

Section: De Block and Associatesmentioning

confidence: 99%

Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

et al. 2000

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Abbreviations: ANOVA, analysis of variance; AUC ROC , area under the curve for receiver operating characteristics; CV, coefficient of variation; Nl, normal range; PCA, parietal cell antibody; sTfR, soluble transferrin receptor.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Soluble Transferrin Receptor LevelA new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetesOBJECTIVE -A total of 15-20% of type 1 diabetic patients have parietal cell antibodies (PCAs). PCA ϩ subjects are at increased risk for iron deficiency anemia and atrophic gastritis. Recently, soluble transferrin receptor (sTfR) levels have proven to be a sensitive indicator for iron deficiency. They are, in contrast with ferritin levels, independent of inflammation, liver and hormonal status, and sex. We are the first to evaluate sTfR levels in type 1 diabetes and tested the hypothesis of higher sTfR levels in patients with PCAs and/or autoimmune gastritis.RESEARCH DESIGN AND METHODS -We examined 148 type 1 diabetic patients (85 men and 63 women; 50 were PCA ϩ ) and 59 sex-and age-matched control subjects (30 men and 29 women). The main outcome measures were sTfR levels, iron deficiency anemia, and atrophic gastritis. Logistical regression analysis tested risk factors for iron deficiency.RESULTS -Iron deficiency was present in 38 subjects. Iron (P Ͻ 0.0001) and ferritin (P Ͻ 0.0001) levels but not sTfR levels were lower in women. sTfR levels were similar in diabetic and control subjects but were higher in PCA ϩ subjects (P = 0.015). In diabetic subjects, iron deficiency anemia was more prevalent in PCA ϩ than in PCA -patients (odds ratio 3.07, P = 0.013) and was associated with sex (P = 0.0001), age (P = 0.046), and sTfR (P = 0.0008) levels. Atrophic gastritis was present in 15 of 28 PCA ϩ and in 1 of 11 PCA -diabetic subjects (P = 0.014). sTfR levels tended to be higher in patients with atrophic gastritis (P = 0.062).CONCLUSIONS -In type 1 diabetes, sTfR levels can be used to diagnose iron deficiency anemia, which is more prevalent in PCA ϩ subjects. sTfR levels are higher in PCA ϩ individuals who are at risk for developing atrophic gastritis.

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Evaluation of kits for measurement of the soluble transferrin receptor

Cited by 45 publications

References 11 publications

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

Hereditary Hemochromatosis: Genetic Complexity and New Diagnostic Approaches

Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

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