دراسة الأدوار المتعددة الأوجه للبروتين العظمي مورفوجينيك (BMP) في تنظيم دوران الحديد في مرضى فقر الدم الناتج عن نقص الحديد

Study the Multifaceted Roles of Bone Morphogenetic Protein (BMP) in the Regulation of Circulating Iron in Iron Deficiency Anemia Patients.

Abstract

The liver has emerged as the major site of systemic iron regulation, being the location where the iron regulatory hormone hepcidin is produced. Hepcidin is a negative regulator of iron absorption and recycling, achieving this by binding to the only known cellular iron exporter ferroportin and causing its internalization and degradation, thereby reducing iron efflux from target cells and reducing serum iron levels. Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-beta (TGF-β) superfamily of signaling molecules. It has a central role in iron homeostasis. Specifically, BMP6 serves to relate hepatic iron stores to the hepatocellular expression of the iron-regulatory hormone hepcidin. Systemic iron regulation maintains a stable concentration of iron-transferrin in plasma and extracellular fluid. Therefore, this study was aimed to investigate the role of BMP isoforms (BMP2 &6) in anemia patients, also to correlate the BMP isoforms levels with the standard and general markers for diagnostic disease. The present work included a case control study for a group of (91) samples: (61) patient samples and (30) healthy control samples. Patients with iron deficiency anemia were selected from the hematology unit, Al Hussein Teaching Medical City. Measurements of serum human bone morphological protein 2& 6 were performed using ELISA Technique. Quantitative measurements of CBC were determined using xp-300 automated hematology analyzer device. The level of both Bone morphogenetic proteins isoforms were increased slightly in IDA patient compared to control group. Analysis of correlation illustrated that Bone morphogenetic proteins 6 in IDA patients has a statistically significant negative correlation with all iron deficiency markers (P<0.05) except total iron binding capacity which has a statistically significant positive correlation. On the other hand, Bone morphogenetic proteins 2 in IDA patients has a statistically significant negative correlation with Free iron and has a statistically significant positive correlation with TIBC (P<0.05) and not statistically correlated with ferritin (P>0.05). In IDA, The ROC test for the BMP 2/ BMP6 ratio diagnostic performance exhibited much better performance than individual values. The study concluded that Bone morphogenetic proteins 2 and 6 and correlated with iron levels in iron deficiency anemia patients. It could provide a view of the complex phenomenon represented by key contributors to the disease outcome, and an increased awareness should be attributed to these biomarkers.