Q.1: What is Ferritin?? Ferritin is a universal intracellular protein that stores iron and releases it in a
controlled fashion. In humans, it acts as a buffer against iron deficiency and iron overload. Ferritin is
a blood protein that contains
iron. Ferritin is a protein
in the body which binds to iron. Most of the iron in the body is bound to ferritin, which is found in the bone marrow, liver,
spleen and skeletal muscle. A ferritin test helps us to
understand how much iron ones has body
stores
Q.2: Which
lead to low ferritin?? Ans: it implies that Her blood ferritin level is lower than
normal, it indicates her body's
iron stores are low and she is having iron deficiency. A result of low ferritin is strong
evidence of an iron
deficiency. . Most laboratories consider
serum ferritin levels greater than 200 ng/mL in women
and greater than 300 ng/mL in men to be abnormal. However, a large percentage
of the general population has a serum ferritin level between 200 and 1,000 ng/mL(normal range). Serum ferritin levels are measured in medical laboratories as part of the iron studies workup for iron-deficiency anemia.[5] The ferritin levels measured usually have a direct
correlation with the total amount of iron stored in the body. However, ferritin
levels may be artificially high in cases of anemia of chronic disease where ferritin is elevated in its capacity as an
inflammatory acute phase protein and not as a marker for iron overload.
Normal
ranges[edit]
A
normal ferritin blood level, referred to as the reference interval is determined by many testing laboratories. The ranges for ferritin can vary between laboratories but
typical ranges would be between 30–300 ng/mL (=μg/L) for males, and
18–160 ng/mL (=μg/L) for females.
|
Men
|
18–270
nanograms per milliliter (ng/mL)
|
|
Women
|
18–160 ng/mL
|
|
Children (6
months to 15 years)
|
7–140 ng/mL
|
|
Infants (1
to 5 months)
|
50–200 ng/mL
|
|
Neonates
|
25–200 ng/mL
|
Deficiency
In
the setting of anemia, low serum ferritin is the most sensitive lab test
for iron-deficiency anemia.[29] However it is less specific, since its levels are
increased in the blood by infection or any type of chronic inflammation,[30] and
these conditions may convert what would otherwise be a low level of ferritin
from lack of iron, into a value in the normal range. For this reason, low
ferritin levels carry more information than those in the normal range.
Low
serum ferritin levels are seen in some patients with restless legs syndrome, not necessarily related to anemia, but perhaps due to low
iron stores short of anemia.
A falsely
low blood ferritin (equivalent to a false positive test) is very uncommon, but can result from
a hook effect of the measuring tools in extreme cases.[33]
Vegetarianism is not a cause of low serum ferritin levels, despite
the common myth. The Position of the American Dietetic Association pointed this
out in 2009 stating, “Incidence of iron-deficiency anemia among vegetarians is
similar to that of non-vegetarians. Although vegetarian adults have lower iron
stores than non-vegetarians, their serum ferritin levels are usually within the
normal range
Excess
If
ferritin is high, there is iron in excess or else there is an acute
inflammatory reaction in which ferritin is mobilized without iron excess. For
example, ferritins may be high in infection without signaling body iron
overload.
Ferritin
is also used as a marker for iron overload
disorders, such as hemochromatosis or hemosiderosis. Adult-onset Still's disease, some porphyrias,
and hemophagocytic lymphohistiocytosis/macrophage activation syndrome are diseases in which the ferritin level may be
abnormally raised. Mitochondrial ferritin has many roles pertaining to molecular function. It
participates in ferroxidase activity, binding, iron ion binding, oxidoreductase
activity, ferric iron binding, metal ion binding as well as transition metal
binding. Within the realm of biological processes it participates in
oxidation-reduction, iron ion transport across membranes and cellular iron ion
homeostasis.
As
ferritin is also an acute-phase reactant, it is often elevated in the course of disease. A normal C-reactive protein can be used to exclude elevated ferritin caused by
acute phase reactions.
Ferritin
has been shown to be elevated in some cases of Covid-19 and may correlate with worse
clinical outcome. According to a study of anorexia nervosa patients, ferritin can be
elevated during periods of acute malnourishment, perhaps due to iron going into
storage as intravascular volume and thus the number of red blood cells falls. Another
study suggests that due to the catabolic nature of anorexia nervosa, isoferritins may be released.
Furthermore, ferritin has significant non-storage roles within the body, such
as protection from oxidative damage. The rise of these isoferritins may
contribute to an overall increase in ferritin concentration. The measurement of
ferritin through immunoassay or immunoturbidimeteric
methods may also be picking up these isoferritins thus not a true reflection of
iron storage status
·
. Q. 3: Which lead to high ferritin?? If a ferritin test
shows higher than
normal levels, it could
indicate that she has a condition that causes body to store too much iron. It
could also point to liver
disease, rheumatoid arthritis, other inflammatory conditions or
hyperthyroidism. Ferritin concentrations increase
drastically in the presence of an infection or cancer. Endotoxins are an up-regulator
of the gene coding for ferritin, thus causing the concentration of ferritin to
rise. By contrast, organisms such as Pseudomonas, although
possessing endotoxin, cause plasma ferritin levels to drop significantly within
the first 48 hours of infection. Thus, the iron stores of the infected body are
denied to the infective agent, impeding its metabolism.
·
Hemochromatosis
·
Porphyria — A group of disorders caused by an enzyme deficiency
that affects your nervous system and skin
·
another chronic inflammatory disorder
·
Hyperthyroidism
·
Leukemia
·
Hodgkin's lymphoma
·
Multiple blood transfusions
·
Alcohol abuse
·
Taking too many iron supplements
If a ferritin test shows higher than normal levels, it could indicate that she have a condition that causes
her body to store too much iron.. Many laboratories consider serum ferritin levels greater than 200 ng/mL in women and greater than 300 ng/mL in men to be abnormal. As mentioned
normal value is However, a large percentage of the general population has a
serum ferritin level between
200 and 1,000 ng/mL.
.
Results
The normal range for blood
ferritin is:
·
For men, 24 to 336 micrograms
per liter
·
For women, 11 to 307
micrograms per liter
In humans, it acts as a buffer
against iron deficiency and iron overload. Ferritin is
found in most tissues as a cytosolic protein, but small amounts are secreted
into the serum where it functions as an iron carrier. Plasma ferritin is also an
indirect marker of the total amount of iron stored in the body;
hence, serum ferritin is used as a diagnostic test for iron-deficiency
anemia. Ferritin serves to store iron in a non-toxic form, to
deposit it in a safe form, and to transport it to areas where it is required. The function and structure of the expressed ferritin
protein varies in different cell types. This is controlled primarily by the
amount and stability of messenger RNA (mRNA), but also by changes in how the mRNA is stored
and how efficiently it is transcribed. Free iron is toxic to cells as it acts as
a catalyst in the formation
of free radicals from reactive oxygen species via the Fenton reaction. Hence vertebrates have an elaborate set of protective
mechanisms to bind iron in various tissue compartments. Within cells, iron is stored in a protein complex as
ferritin or the related complex hemosiderin.
Apoferritin binds
to free ferrous iron and stores it in the ferric state. As ferritin accumulates
within cells of the reticuloendothelial system, protein
aggregates are formed as hemosiderin.
Iron in ferritin or hemosiderin can be extracted for release by the RE cells,
although hemosiderin is less readily available. Under steady-state conditions, the level of ferritin in the blood
serum correlates with total body
stores of iron; thus, the serum ferritin FR5Rl is the most convenient
laboratory test to estimate iron stores.
Ferritin
is a globular protein complex consisting of 24 protein subunits forming a
nanocage with multiple metal–protein interactions. It is the primary intracellular
iron-storage protein in both prokaryotes and eukaryotes, keeping iron in a soluble and non-toxic form. Ferritin
that is not combined with iron is called apoferritin.
Ferritin
gens:-In human ferritin, introns are present between amino
acid residues 14
and 15, 34 and 35, and 82 and 83; in addition, there are one to two
hundred untranslated bases at either end of the
combined exons. The tyrosine residue at amino acid position 27 is thought to be
associated with biomineralization.
Ferritin is a hollow globular protein of mass 474 kDa and comprising 24 subunits. It is present
in every cell type. Typically it has internal and external diameters of
about 8 and 12 nm, respectively. The nature of these subunits varies by
class of organism
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